2010 Medicare Part D Plan Formulary Information |
AmeriHealth Rx Option II (PDP) (S2321-002-0)
Benefit Details
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The AmeriHealth Rx Option II (PDP) (S2321-002-0) Formulary Drugs Starting with the Letter A in CMS PDP Region 6 which includes: PA WV
|
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 WV cover A METHAPRED METHLYPREDNISOLONE SODIUM SUCCINATE FOR INJECTION 125 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
A-HYDROCORT 100MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover A-HYDROCORT 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
A-METHAPRED 40MG UNIVIAL ![Compare how all Medicare Part D PDP plans in WV cover A-METHAPRED 40MG UNIVIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ABILIFY 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY 20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY 2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY 30MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY 5MG TABLET (OTSUKA) ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY 5MG TABLET (OTSUKA).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
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 WV cover ABILIFY DISCMELT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY DISCMELT 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY DISCMELT 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABILIFY INJ 9.75MG ![Compare how all Medicare Part D PDP plans in WV cover ABILIFY INJ 9.75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ACARBOSE 100MG TABLET S ![Compare how all Medicare Part D PDP plans in WV cover ACARBOSE 100MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACARBOSE 25MG TABLET S ![Compare how all Medicare Part D PDP plans in WV cover ACARBOSE 25MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACARBOSE 50MG TABLET S ![Compare how all Medicare Part D PDP plans in WV cover ACARBOSE 50MG TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACCUNEB 0.63MG/3ML INH TUBEX ![Compare how all Medicare Part D PDP plans in WV cover ACCUNEB 0.63MG/3ML INH TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUNEB 1.25MG/3ML INH TUBEX ![Compare how all Medicare Part D PDP plans in WV cover ACCUNEB 1.25MG/3ML INH TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUPRIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCUPRIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUPRIL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCUPRIL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACCUPRIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCUPRIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUPRIL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCUPRIL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCURETIC 10-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCURETIC 10-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCURETIC 20-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCURETIC 20-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCURETIC 20-25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACCURETIC 20-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUTANE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ACCUTANE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUTANE 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ACCUTANE 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACCUTANE 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ACCUTANE 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACEBUTOLOL 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ACEBUTOLOL 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ACEBUTOLOL 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ACEBUTOLOL 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | 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 WV 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) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | Q:2700 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | Q:180 /30Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-60MG (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-60MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | Q:180 /30Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | Q:180 /30Days |
ACETASOL HC OTIC SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover ACETASOL HC OTIC SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETASOL HC SOLUTION 10ML 10 ML BOT ![Compare how all Medicare Part D PDP plans in WV cover ACETASOL HC SOLUTION 10ML 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETIC ACID 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in WV cover ACETIC ACID 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETIC ACID IN AQUEOUS ALUMINUM ACETATE OTIC SOLUTION 2% 60 ML BOT ![Compare how all Medicare Part D PDP plans in WV cover ACETIC ACID IN AQUEOUS ALUMINUM ACETATE OTIC SOLUTION 2% 60 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in WV cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN ![Compare how all Medicare Part D PDP plans in WV cover ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACIPHEX 20MG TABLET EC ![Compare how all Medicare Part D PDP plans in WV cover ACIPHEX 20MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /30Days |
ACLOVATE ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT(GM) TOPICAL ![Compare how all Medicare Part D PDP plans in WV cover ACLOVATE ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT(GM) TOPICAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACLOVATE CREAM 0.05% 15GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover ACLOVATE CREAM 0.05% 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACTHIB VACCINE VIAL 10-24UNT/5ML ![Compare how all Medicare Part D PDP plans in WV cover ACTHIB VACCINE VIAL 10-24UNT/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTICIN 5% CREAM ![Compare how all Medicare Part D PDP plans in WV cover ACTICIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACTIGALL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ACTIGALL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACTIMMUNE SOLUTION FOR INJECTION 100MCG ![Compare how all Medicare Part D PDP plans in WV cover ACTIMMUNE SOLUTION FOR INJECTION 100MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ACTIQ 1200MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WV cover ACTIQ 1200MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:120 /30Days |
ACTIQ 1600MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WV cover ACTIQ 1600MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:120 /30Days |
ACTIQ 200MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WV cover ACTIQ 200MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTIQ 400MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WV cover ACTIQ 400MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:120 /30Days |
ACTIQ 600MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WV cover ACTIQ 600MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:120 /30Days |
ACTIQ 800MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WV cover ACTIQ 800MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:120 /30Days |
ACTIVELLA 1-0.5MG TABLET 28 DLPK ![Compare how all Medicare Part D PDP plans in WV cover ACTIVELLA 1-0.5MG TABLET 28 DLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ACTONEL 150MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTONEL 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:1 /30Days |
ACTONEL 30MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTONEL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTONEL 35MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTONEL 35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:4 /30Days |
ACTONEL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTONEL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTONEL 75MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTONEL 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:2 /30Days |
ACTONEL WITH CALCIUM TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTONEL WITH CALCIUM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTOPLUS MET 15MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTOPLUS MET 15MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTOPLUS MET 15MG/850MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTOPLUS MET 15MG/850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTOS 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTOS 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTOS 30MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACTOS 30MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACTOS 45MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ACTOS 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACULAR 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover ACULAR 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ACULAR LS 0.4% OPHTH SOL ![Compare how all Medicare Part D PDP plans in WV cover ACULAR LS 0.4% OPHTH SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ACYCLOVIR 200MG CAPSULE (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACYCLOVIR 200MG CAPSULE (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACYCLOVIR 200MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WV cover ACYCLOVIR 200MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACYCLOVIR 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACYCLOVIR 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ACYCLOVIR SODIUM 500MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover ACYCLOVIR SODIUM 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ACYCLOVIR TABLET USP 800MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ACYCLOVIR TABLET USP 800MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in WV cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ADALAT CC 30MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADALAT CC 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADALAT CC 60MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADALAT CC 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADALAT CC 90MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADALAT CC 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADCIRCA TABLETS 20MG 60 BOT ![Compare how all Medicare Part D PDP plans in WV cover ADCIRCA TABLETS 20MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P |
ADDERALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL 30MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADDERALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL XR 10MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL XR 10MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL XR 15MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL XR 15MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL XR 20MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL XR 20MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL XR 25MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL XR 25MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL XR 30MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL XR 30MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADDERALL XR 5MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover ADDERALL XR 5MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADOXA 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADOXA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADOXA 50MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADOXA 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADOXA PAK 100MG TABLET DSPK-31 ![Compare how all Medicare Part D PDP plans in WV cover ADOXA PAK 100MG TABLET DSPK-31.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADOXA PAK 100MG TABLET DSPK-60 ![Compare how all Medicare Part D PDP plans in WV cover ADOXA PAK 100MG TABLET DSPK-60.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADOXA PAK 150MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADOXA PAK 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADOXA PAK 75MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ADOXA PAK 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ADVAIR DISKU MIS 100/50 ![Compare how all Medicare Part D PDP plans in WV cover ADVAIR DISKU MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ADVAIR DISKU MIS 250/50 ![Compare how all Medicare Part D PDP plans in WV cover ADVAIR DISKU MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ADVAIR DISKU MIS 500/50 ![Compare how all Medicare Part D PDP plans in WV cover ADVAIR DISKU MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
AGRYLIN 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AGRYLIN 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AK-CON 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover AK-CON 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AK-POLY-BAC EYE OINTMENT 500UNT/1000UNT ![Compare how all Medicare Part D PDP plans in WV cover AK-POLY-BAC EYE OINTMENT 500UNT/1000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AKTOB 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover AKTOB 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALA-CORT 1% CREAM ![Compare how all Medicare Part D PDP plans in WV cover ALA-CORT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALA-CORT 1% LOTION ![Compare how all Medicare Part D PDP plans in WV cover ALA-CORT 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALA-SCALP HP 2% LOTION ![Compare how all Medicare Part D PDP plans in WV cover ALA-SCALP HP 2% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ALBUTEROL SULFATE 0.63MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE 0.63MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL SULFATE 2.5MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE 2.5MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL SULFATE TABLET 2MG (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL SULFATE TABLET 2MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALBUTEROL TABLET 4MG (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover ALBUTEROL TABLET 4MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALCAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover ALCAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALCLOMETASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WV cover ALCLOMETASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover ALCLOMETASONE DIPROPIONATE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALDACTAZIDE 25/25 TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALDACTAZIDE 25/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALDACTONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALDACTONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALDACTONE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALDACTONE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALDACTONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALDACTONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALDARA IMIQUIMOD CREAM 5% 24 PKT X 250 MG CRTN ![Compare how all Medicare Part D PDP plans in WV cover ALDARA IMIQUIMOD CREAM 5% 24 PKT X 250 MG CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ALENDRONATE SODIUM 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALENDRONATE SODIUM 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ALENDRONATE SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALENDRONATE SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ALENDRONATE SODIUM 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALENDRONATE SODIUM 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ALENDRONATE SODIUM 70MG TABLET 4 BLPK ![Compare how all Medicare Part D PDP plans in WV cover ALENDRONATE SODIUM 70MG TABLET 4 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | Q:4 /30Days |
ALENDRONATE SODIUM TABLET 35MG 20 CRTN ![Compare how all Medicare Part D PDP plans in WV cover ALENDRONATE SODIUM TABLET 35MG 20 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | Q:4 /30Days |
ALIMTA 500MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover ALIMTA 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ALINIA 100MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover ALINIA 100MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ALINIA 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALINIA 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ALKERAN FOR INJECTION 50MG/VIAL 1 VIALSU ![Compare how all Medicare Part D PDP plans in WV cover ALKERAN FOR INJECTION 50MG/VIAL 1 VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ALLEGRA 180MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALLEGRA 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALLEGRA 30MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in WV cover ALLEGRA 30MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALLEGRA 60MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ALLEGRA 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALLOPURINOL TABLET 300MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover ALLOPURINOL TABLET 300MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALLOPURINOL TABLET USP 100MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover ALLOPURINOL TABLET USP 100MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ALORA 0.025MG PATCH ![Compare how all Medicare Part D PDP plans in WV cover ALORA 0.025MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ALORA 0.05MG PATCH ![Compare how all Medicare Part D PDP plans in WV cover ALORA 0.05MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ALORA 0.075MG PATCH ![Compare how all Medicare Part D PDP plans in WV cover ALORA 0.075MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ALORA 0.1MG PATCH ![Compare how all Medicare Part D PDP plans in WV cover ALORA 0.1MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in WV cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ALPHAGAN P 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover ALPHAGAN P 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALTABAX 1% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover ALTABAX 1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ALTACE 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ALTACE 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ALTACE 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ALTACE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE TABLETS 1.25MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WV cover ALTACE TABLETS 1.25MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE TABLETS 10MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WV cover ALTACE TABLETS 10MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE TABLETS 2.5MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WV cover ALTACE TABLETS 2.5MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALTACE TABLETS 5MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WV cover ALTACE TABLETS 5MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALVESCO 160MCG/ACT AERS ![Compare how all Medicare Part D PDP plans in WV cover ALVESCO 160MCG/ACT AERS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ALVESCO 80MCG/ACT AERS ![Compare how all Medicare Part D PDP plans in WV cover ALVESCO 80MCG/ACT AERS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMANTADINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMANTADINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMARYL 1MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMARYL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AMARYL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMARYL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AMARYL 4MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMARYL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AMBIEN 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMBIEN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:14 /14Days |
AMBIEN CR 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMBIEN CR 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /30Days |
AMBIEN CR 6.25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMBIEN CR 6.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /30Days |
AMBIEN TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover AMBIEN TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:14 /14Days |
AMCINONIDE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WV cover AMCINONIDE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMCINONIDE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in WV cover AMCINONIDE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | 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 WV cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMEVIVE ADMISTRATION PACK FOR INTRAMUSCULAR ADMINISTRATION KIT 15MG 1 X 4 PKGCOM ![Compare how all Medicare Part D PDP plans in WV cover AMEVIVE ADMISTRATION PACK FOR INTRAMUSCULAR ADMINISTRATION KIT 15MG 1 X 4 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AMIFOSTINE FOR INJECTION 500MG/VIAL ![Compare how all Medicare Part D PDP plans in WV cover AMIFOSTINE FOR INJECTION 500MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMIKACIN 250MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover AMIKACIN 250MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMILORIDE HCL W/HCTZ 5MG-50MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMILORIDE HCL W/HCTZ 5MG-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMINOPHYLLINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMINOPHYLLINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMINOPHYLLINE 200MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMINOPHYLLINE 200MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMIODARONE HCL 200MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMIODARONE HCL 200MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMIODARONE HCL 400MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMIODARONE HCL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMIODARONE HCL INJECTION ![Compare how all Medicare Part D PDP plans in WV cover AMIODARONE HCL INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIP/PERPHEN 10-2 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIP/PERPHEN 10-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIP/PERPHEN 25-2 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIP/PERPHEN 25-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIP/PERPHEN 25-4 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIP/PERPHEN 25-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIPTYLINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMITRIPTYLINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMITRIPTYLINE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 25MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMITRIPTYLINE HCL 25MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 75MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMITRIPTYLINE HCL 75MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover AMITRIPTYLINE HCL TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMLODIPINE BESYLATE 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE 2.5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMLODIPINE BESYLATE 5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE 5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
AMMONIUM LACTATE 12% CREAM ![Compare how all Medicare Part D PDP plans in WV cover AMMONIUM LACTATE 12% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in WV cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMNESTEEM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMNESTEEM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMNESTEEM 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMNESTEEM 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMNESTEEM 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMNESTEEM 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOCLAN 200-28.5/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in WV cover AMOCLAN 200-28.5/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOCLAN 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in WV cover AMOCLAN 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in WV cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in WV cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in WV cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in WV cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 500-125MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOX TR-POTASSIUM CLAVULANATE 500-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 200MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 200MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 400MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 400MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXICILLIN TABLET USP CHEWABLE 250MG (250 CT) ![Compare how all Medicare Part D PDP plans in WV cover AMOXICILLIN TABLET USP CHEWABLE 250MG (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMOXIL 250MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover AMOXIL 250MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AMOXIL 400MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover AMOXIL 400MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AMOXIL CAPSULES 500MG ![Compare how all Medicare Part D PDP plans in WV cover AMOXIL CAPSULES 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AMPHET ASP/ AMPHET/ D-AMPHET 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMPHET ASP/ AMPHET/ D-AMPHET 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALT COMBO 30MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMPHETAMINE SALT COMBO 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALTS 20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AMPHETAMINE SALTS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN AND SULBACTAM FOR INJECTION 2-1 10 VIAL ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN AND SULBACTAM FOR INJECTION 2-1 10 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN FOR INJECTION POWDER ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN FOR INJECTION POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AMPICILLIN POWDER FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in WV cover AMPICILLIN POWDER FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMRIX 30MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in WV cover AMRIX 30MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AMRIX CAPSULES EXTENDED RELEASE 15MG 60 CAPSULES BOT ![Compare how all Medicare Part D PDP plans in WV cover AMRIX CAPSULES EXTENDED RELEASE 15MG 60 CAPSULES BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANADROL-50 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ANADROL-50 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ANAFRANIL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ANAFRANIL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANAFRANIL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ANAFRANIL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANAFRANIL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ANAFRANIL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANAGRELIDE HCL 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ANAGRELIDE HCL 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ANAGRELIDE HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ANAGRELIDE HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ANAPROX 275MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANAPROX 275MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANAPROX DS 550MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANAPROX DS 550MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANDROGEL 1%(50MG) GEL PACKET ![Compare how all Medicare Part D PDP plans in WV cover ANDROGEL 1%(50MG) GEL PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANDROID 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ANDROID 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANTABUSE 250MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANTABUSE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ANTABUSE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANTABUSE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ANTIVERT 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANTIVERT 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANTIVERT 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANTIVERT 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANTIZOL INJECTION 1GM 4 X 1.5ML VIAL CRTN ![Compare how all Medicare Part D PDP plans in WV cover ANTIZOL INJECTION 1GM 4 X 1.5ML VIAL CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANUSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in WV cover ANUSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ANZEMET 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANZEMET 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:6 /30Days |
ANZEMET 50MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ANZEMET 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:6 /30Days |
APAP-CAFFEINE-DIHYDROCODE TAB 30 EA ![Compare how all Medicare Part D PDP plans in WV cover APAP-CAFFEINE-DIHYDROCODE TAB 30 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | Q:180 /30Days |
APLENZIN TABLETS EXTENDED RELEASE 348 MG ![Compare how all Medicare Part D PDP plans in WV cover APLENZIN TABLETS EXTENDED RELEASE 348 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APLENZIN TABLETS EXTENDED RELEASE 522 MG ![Compare how all Medicare Part D PDP plans in WV cover APLENZIN TABLETS EXTENDED RELEASE 522 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
APOKYN FOR INJECTION 30MG 5 CTG ![Compare how all Medicare Part D PDP plans in WV cover APOKYN FOR INJECTION 30MG 5 CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in WV cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in WV cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARALAST 500MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARALAST 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ARALEN PHOSPHATE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARALEN PHOSPHATE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ARANESP 100MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 100MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP 200MCG/0.4ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 200MCG/0.4ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP 200MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 200MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP 25MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 25MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /7Days |
ARANESP 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP 500MCG/1ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 500MCG/1ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP 60MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARANESP 60MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP PREFILLED SYRINGE SINGLE USE 100MCG/0.5ML 1 SYR ![Compare how all Medicare Part D PDP plans in WV cover ARANESP PREFILLED SYRINGE SINGLE USE 100MCG/0.5ML 1 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR ![Compare how all Medicare Part D PDP plans in WV cover ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP PREFILLED SYRINGE SINGLE USE 25MCG/0.42ML SYR ![Compare how all Medicare Part D PDP plans in WV cover ARANESP PREFILLED SYRINGE SINGLE USE 25MCG/0.42ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /7Days |
ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR ![Compare how all Medicare Part D PDP plans in WV 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 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR ![Compare how all Medicare Part D PDP plans in WV cover ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /7Days |
ARANESP PREFILLED SYRINGE SINGLE USE 60MCG/0.3ML 60MCG/ 0.3ML SYR ![Compare how all Medicare Part D PDP plans in WV 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 |
Specialty |
30% | 30% | P Q:30 /7Days |
ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD ![Compare how all Medicare Part D PDP plans in WV cover ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P Q:30 /7Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARAVA 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARAVA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ARAVA 20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARAVA 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in WV cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | None |
ARICEPT 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARICEPT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARICEPT 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARICEPT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARICEPT ODT 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARICEPT ODT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARICEPT ODT 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARICEPT ODT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARIMIDEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ARIMIDEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
ARIXTRA 10MG SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ARIXTRA 10MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARIXTRA 2.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ARIXTRA 2.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ARIXTRA 5MG SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ARIXTRA 5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARIXTRA 7.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ARIXTRA 7.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AROMASIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AROMASIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ASACOL 400MG TABLET EC ![Compare how all Medicare Part D PDP plans in WV cover ASACOL 400MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ASCOMP W/CODEINE 30-50-325 CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ASCOMP W/CODEINE 30-50-325 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | Q:180 /30Days |
ASTELIN 137MCG AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in WV cover ASTELIN 137MCG AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ASTRAMORPH-PF 0.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ASTRAMORPH-PF 0.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ASTRAMORPH-PF 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover ASTRAMORPH-PF 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATACAND 16MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ATACAND 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATACAND 32MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ATACAND 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATACAND 4MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ATACAND 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATACAND 8MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ATACAND 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATACAND HCT 16/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ATACAND HCT 16/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATACAND HCT 32/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ATACAND HCT 32/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATACAND HCT TABLETS 32;25MG;MG 90 TABLETS BOT ![Compare how all Medicare Part D PDP plans in WV cover ATACAND HCT TABLETS 32;25MG;MG 90 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATAMET ![Compare how all Medicare Part D PDP plans in WV cover ATAMET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ATENOLOL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ATENOLOL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ATENOLOL TABLET USP 50MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ATENOLOL TABLET USP 50MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ATENOLOL TABLETS USP 100MG 1 BLPK ![Compare how all Medicare Part D PDP plans in WV cover ATENOLOL TABLETS USP 100MG 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$7.00 | $14.00 | None |
ATGAM 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in WV cover ATGAM 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | P |
ATRIPLA TABLET 600MG/200MG ![Compare how all Medicare Part D PDP plans in WV cover ATRIPLA TABLET 600MG/200MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATROPINE 0.1MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ATROPINE 0.1MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in WV cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
ATROVENT NASAL SPRAY 0.03% ![Compare how all Medicare Part D PDP plans in WV cover ATROVENT NASAL SPRAY 0.03%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATROVENT NASAL SPRAY 0.06% ![Compare how all Medicare Part D PDP plans in WV cover ATROVENT NASAL SPRAY 0.06%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
ATTENUVAX VACCINE W/DILUENT 1 DOSE/0.5ML ![Compare how all Medicare Part D PDP plans in WV cover ATTENUVAX VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AUGMENTIN 125 SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN 125 SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
AUGMENTIN 250 SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN 250 SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
AUGMENTIN 250 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN 250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AUGMENTIN 400MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN 400MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AUGMENTIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AUGMENTIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AUGMENTIN ES-600 SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN ES-600 SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AUGMENTIN TABLETS COMBO ![Compare how all Medicare Part D PDP plans in WV cover AUGMENTIN TABLETS COMBO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None |
AVALIDE 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVALIDE 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVALIDE 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVALIDE 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVALIDE 300-25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVALIDE 300-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVANDAMET 2MG/1000MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDAMET 2MG/1000MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDAMET 2MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDAMET 2MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDAMET 4MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDAMET 4MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDAMET TABLET 4-1000MG ![Compare how all Medicare Part D PDP plans in WV cover AVANDAMET TABLET 4-1000MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDARYL 4MG/1MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDARYL 4MG/1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDARYL 4MG/2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDARYL 4MG/2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVANDARYL 4MG/4MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDARYL 4MG/4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDARYL 8MG-2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDARYL 8MG-2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDARYL 8MG-4MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDARYL 8MG-4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDIA 2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVANDIA 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDIA 4MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WV cover AVANDIA 4MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVANDIA 8MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WV cover AVANDIA 8MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AVAPRO 150MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVAPRO 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVAPRO 300MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVAPRO 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVAPRO 75MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover AVAPRO 75MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in WV cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AVINZA 120MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in WV cover AVINZA 120MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVINZA 30MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in WV cover AVINZA 30MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:30 /30Days |
AVINZA 60MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in WV cover AVINZA 60MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:30 /30Days |
AVINZA 90MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in WV cover AVINZA 90MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:30 /30Days |
AVINZA CAPSULES EXTENDED RELEASE 45MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WV cover AVINZA CAPSULES EXTENDED RELEASE 45MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:30 /30Days |
AVINZA CAPSULES EXTENDED RELEASE 75MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WV cover AVINZA CAPSULES EXTENDED RELEASE 75MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | Q:30 /30Days |
AVITA 0.025% CREAM ![Compare how all Medicare Part D PDP plans in WV cover AVITA 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AVONEX ADMIN PACK 30MCG SYR ![Compare how all Medicare Part D PDP plans in WV cover AVONEX ADMIN PACK 30MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | Q:4 /30Days |
AVONEX ADMIN PACK 30MCG VL ![Compare how all Medicare Part D PDP plans in WV cover AVONEX ADMIN PACK 30MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty |
30% | 30% | Q:4 /30Days |
AXID 150MG PULVULE ![Compare how all Medicare Part D PDP plans in WV cover AXID 150MG PULVULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AXID 300MG PULVULE ![Compare how all Medicare Part D PDP plans in WV cover AXID 300MG PULVULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AYGESTIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AYGESTIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZACTAM 2GM VIAL ![Compare how all Medicare Part D PDP plans in WV cover AZACTAM 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AZACTAM INJECTION 1GM 50ML BAG ![Compare how all Medicare Part D PDP plans in WV cover AZACTAM INJECTION 1GM 50ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AZACTAM/ISO-OSMOT 2GM/50ML ![Compare how all Medicare Part D PDP plans in WV cover AZACTAM/ISO-OSMOT 2GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AZASAN 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AZASAN 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZASAN 75MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AZASAN 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZATHIOPRINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AZATHIOPRINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | P |
AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in WV cover AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in WV cover AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN 250MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover AZITHROMYCIN 250MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN 500MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover AZITHROMYCIN 500MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN FOR INJECTION 500MG 10 VIALSD ![Compare how all Medicare Part D PDP plans in WV cover AZITHROMYCIN FOR INJECTION 500MG 10 VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZITHROMYCIN TABLET 600MG (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover AZITHROMYCIN TABLET 600MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None |
AZMACORT INHALATION AEROSOL .1MG/1IHL 20 GM CSTR ![Compare how all Medicare Part D PDP plans in WV cover AZMACORT INHALATION AEROSOL .1MG/1IHL 20 GM CSTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in WV cover AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | $70.00 | None |
AZOR 10MG-20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AZOR 10MG-20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZOR 10MG-40MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover AZOR 10MG-40MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZOR 5MG-20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover AZOR 5MG-20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZOR 5MG-40MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AZOR 5MG-40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZULFIDINE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover AZULFIDINE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |
AZULFIDINE EN TABLET S 500MG TABLET 6 X (300 CT)PL ![Compare how all Medicare Part D PDP plans in WV cover AZULFIDINE EN TABLET S 500MG TABLET 6 X (300 CT)PL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | P |