2011 Medicare Part D Plan Formulary Information |
Clarian Medicare Select Plus (HMO) (H7220-003-0)
Benefit Details
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The Clarian Medicare Select Plus (HMO) (H7220-003-0) Formulary Drugs Starting with the Letter C in Vermillion County, IN: CMS MA Region 13 which includes: IN
|
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CABERGOLINE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CABERGOLINE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CADUET 10MG/10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 10MG/10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 10MG/20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 10MG/20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 10MG/40MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 10MG/40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 10MG/80MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 10MG/80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 2.5MG/10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 2.5MG/10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 2.5MG/20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 2.5MG/20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 2.5MG/40MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 2.5MG/40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 5MG/10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 5MG/10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 5MG/20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 5MG/20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CADUET 5MG/40MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 5MG/40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CADUET 5MG/80MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CADUET 5MG/80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CAFERGOT EROGOTAMINE TARTRATE AND CAFFINE TABLETS 1;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CAFERGOT EROGOTAMINE TARTRATE AND CAFFINE TABLETS 1;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:40 /30Days |
CALAN 120MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CALAN 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALAN 80MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CALAN 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALAN SR 120MG CAPLET SA ![Compare how all Medicare Part D PDP plans in IN cover CALAN SR 120MG CAPLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALAN SR 180MG CAPLET SA ![Compare how all Medicare Part D PDP plans in IN cover CALAN SR 180MG CAPLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALAN SR TABLET 240MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CALAN SR TABLET 240MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALCIPOTRIENE OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover CALCIPOTRIENE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CALCIPOTRIENE TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CALCIPOTRIENE TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in IN cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CALCITRIOL 0.00025 MG ORAL CAPSULE [ROCALTROL] ![Compare how all Medicare Part D PDP plans in IN cover CALCITRIOL 0.00025 MG ORAL CAPSULE [ROCALTROL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALCITRIOL 0.0005 MG ORAL CAPSULE [ROCALTROL] ![Compare how all Medicare Part D PDP plans in IN cover CALCITRIOL 0.0005 MG ORAL CAPSULE [ROCALTROL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALCITRIOL 0.001 MG/ML ORAL SOLUTION [ROCALTROL] ![Compare how all Medicare Part D PDP plans in IN cover CALCITRIOL 0.001 MG/ML ORAL SOLUTION [ROCALTROL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CALCITRIOL 0.25MCG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CALCITRIOL 0.25MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CALCITRIOL 0.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CALCITRIOL 0.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CALCITRIOL 1MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in IN cover CALCITRIOL 1MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in IN cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CALCIUM CHLORIDE 0.0014 MEQ/ML / POTASSIUM CHLORIDE 0.004 MEQ/ML / SODIUM CHLORIDE 0.103 MEQ/ML / SO ![Compare how all Medicare Part D PDP plans in IN cover CALCIUM CHLORIDE 0.0014 MEQ/ML / POTASSIUM CHLORIDE 0.004 MEQ/ML / SODIUM CHLORIDE 0.103 MEQ/ML / SO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAMILA 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAMILA 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAMPATH 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CAMPATH 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CAMPRAL 333MG DOSE PAK ![Compare how all Medicare Part D PDP plans in IN cover CAMPRAL 333MG DOSE PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAMPTOSAR 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CAMPTOSAR 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX ![Compare how all Medicare Part D PDP plans in IN cover CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CAPREOMYCIN 500 MG/ML INJECTABLE SOLUTION [CAPASTAT] ![Compare how all Medicare Part D PDP plans in IN cover CAPREOMYCIN 500 MG/ML INJECTABLE SOLUTION [CAPASTAT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CAPTOPRIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL/HCTZ 25/15 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL/HCTZ 25/15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL/HCTZ 25/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL/HCTZ 25/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL/HCTZ 50/15 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL/HCTZ 50/15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CAPTOPRIL/HCTZ 50/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CAPTOPRIL/HCTZ 50/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARAC CRE 0.5% ![Compare how all Medicare Part D PDP plans in IN cover CARAC CRE 0.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CARAFATE SUCRALFATE 1G TABLET ORAL ![Compare how all Medicare Part D PDP plans in IN cover CARAFATE SUCRALFATE 1G TABLET ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARBAMAZEPINE EXTENDED RELEASE TABLETS 200MG ![Compare how all Medicare Part D PDP plans in IN cover CARBAMAZEPINE EXTENDED RELEASE TABLETS 200MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBAMAZEPINE EXTENDED RELEASE TABLETS 400MG ![Compare how all Medicare Part D PDP plans in IN cover CARBAMAZEPINE EXTENDED RELEASE TABLETS 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBAMAZEPINE ORAL SUSPENSION 200 MG ![Compare how all Medicare Part D PDP plans in IN cover CARBAMAZEPINE ORAL SUSPENSION 200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBAMAZEPINE TABLET CHEWABLE 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARBAMAZEPINE TABLET CHEWABLE 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBAMAZEPINE TABLET USP 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARBAMAZEPINE TABLET USP 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBATROL 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover CARBATROL 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CARBATROL 200MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover CARBATROL 200MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CARBATROL 300MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover CARBATROL 300MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CARBIDOPA-LEVODOPA 25MG-100MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover CARBIDOPA-LEVODOPA 25MG-100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA-LEVODOPA 50MG-200MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover CARBIDOPA-LEVODOPA 50MG-200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBIDOPA/LEVO 10/100 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARBIDOPA/LEVO 10/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBIDOPA/LEVO 25/100 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARBIDOPA/LEVO 25/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBIDOPA/LEVO 25/250 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARBIDOPA/LEVO 25/250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARBOPLATIN INJECTION ![Compare how all Medicare Part D PDP plans in IN cover CARBOPLATIN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARDIZEM 120MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDIZEM 30MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDIZEM 60MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDIZEM 90MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDIZEM CAPSULES 180MG (90 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM CAPSULES 180MG (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDIZEM CD 120MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM CD 120MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARDIZEM CD 240MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM CD 240MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDIZEM CD 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in IN cover CARDIZEM CD 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDURA 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDURA 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDURA 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDURA 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDURA 4MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDURA 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARDURA 8MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARDURA 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARIMUNE NF 3GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover CARIMUNE NF 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CARISOPRODOL AND ASPIRIN TABLETS USP 325;200MG;MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in IN cover CARISOPRODOL AND ASPIRIN TABLETS USP 325;200MG;MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARISOPRODOL ASPIRIN AND CODEINE PHOSPHATE TABLETS USP 325;200;16MG;MG;MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in IN cover CARISOPRODOL ASPIRIN AND CODEINE PHOSPHATE TABLETS USP 325;200;16MG;MG;MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARISOPRODOL TABLET USP 350MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARISOPRODOL TABLET USP 350MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARMOL HC 1%-10% CREAM ![Compare how all Medicare Part D PDP plans in IN cover CARMOL HC 1%-10% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARNITOR 100MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in IN cover CARNITOR 100MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARNITOR 330MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CARNITOR 330MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARTIA XT 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in IN cover CARTIA XT 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARVEDILOL 12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARVEDILOL 12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARVEDILOL 25MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARVEDILOL 25MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARVEDILOL 3.125MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARVEDILOL 3.125MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CARVEDILOL 6.25MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CARVEDILOL 6.25MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CASODEX 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CASODEX 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CATAFLAM 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CATAFLAM 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CATAPRES 0.1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CATAPRES 0.1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CATAPRES 0.2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CATAPRES 0.2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CATAPRES 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CATAPRES 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CATAPRES-TTS DIS 0.3/24HR ![Compare how all Medicare Part D PDP plans in IN cover CATAPRES-TTS DIS 0.3/24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CATAPRES-TTS-1 PATCH 2.52.5MG/UNT 1 X 4 CRTN ![Compare how all Medicare Part D PDP plans in IN cover CATAPRES-TTS-1 PATCH 2.52.5MG/UNT 1 X 4 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CATAPRES-TTS-2 PATCH 52.5MG/UNT 1 X 4 CRTN ![Compare how all Medicare Part D PDP plans in IN cover CATAPRES-TTS-2 PATCH 52.5MG/UNT 1 X 4 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CEENU 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CEENU 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CEENU 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CEENU 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CEENU 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CEENU 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFACLOR 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover CEFACLOR 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFACLOR 375MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover CEFACLOR 375MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFACLOR CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover CEFACLOR CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFACLOR CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover CEFACLOR CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFACLOR ER 500MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in IN cover CEFACLOR ER 500MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFACLOR POWDER FOR ORAL SUSPENSION USP 125MG 75ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CEFACLOR POWDER FOR ORAL SUSPENSION USP 125MG 75ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFADROXIL 1G TABLET ![Compare how all Medicare Part D PDP plans in IN cover CEFADROXIL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFADROXIL 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CEFADROXIL 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFADROXIL 500MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IN cover CEFADROXIL 500MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFADROXIL FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CEFADROXIL FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFAZOLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover CEFAZOLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IN cover CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFDINIR CAPSULES 300MG (60 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEFDINIR CAPSULES 300MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in IN cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFEPIME INJ 1GM 20ML APX 10x1G VIAL ![Compare how all Medicare Part D PDP plans in IN cover CEFEPIME INJ 1GM 20ML APX 10x1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPODOXIME PROXETIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CEFPODOXIME PROXETIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 50MG 50ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 50MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPROZIL 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEFPROZIL 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPROZIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IN cover CEFPROZIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFPROZIL FOR ORAL SUSPENSION 125MG/5ML 75ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CEFPROZIL FOR ORAL SUSPENSION 125MG/5ML 75ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFPROZIL TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CEFPROZIL TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFTIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CEFTIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CEFTIN 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover CEFTIN 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CEFTIN 500MG TABLET (20 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEFTIN 500MG TABLET (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CEFUROXIME 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CEFUROXIME 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFUROXIME AXETIL 125MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IN cover CEFUROXIME AXETIL 125MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFUROXIME AXETIL 500MG TABLET (20 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEFUROXIME AXETIL 500MG TABLET (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in IN cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CELEBREX 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CELEBREX 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | S |
CELEBREX 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CELEBREX 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CELEBREX 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CELEBREX 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | S |
CELEBREX 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CELEBREX 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | S |
CELEXA 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CELEXA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELEXA 20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CELEXA 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELEXA 40MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CELEXA 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELLCEPT 200MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover CELLCEPT 200MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELLCEPT 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CELLCEPT 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELLCEPT CAPSULES 250MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CELLCEPT CAPSULES 250MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELLCEPT IV INJ 500MG ![Compare how all Medicare Part D PDP plans in IN cover CELLCEPT IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CELONTIN 300MG KAPSEAL ![Compare how all Medicare Part D PDP plans in IN cover CELONTIN 300MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CENESTIN 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CENESTIN 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CENESTIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CENESTIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CENESTIN 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CENESTIN 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CENESTIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CENESTIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CENESTIN 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CENESTIN 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CEPHALEXIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CEPHALEXIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEPHALEXIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CEPHALEXIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEPHALEXIN 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover CEPHALEXIN 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEPHALEXIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CEPHALEXIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEPHALEXIN CAPSULES 500MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CEPHALEXIN CAPSULES 500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEPHALEXIN POWDER FOR SUSPENSION ORAL USP 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CEPHALEXIN POWDER FOR SUSPENSION ORAL USP 125MG 200ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CEREBYX 100 MG PE/2 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CEREBYX 100 MG PE/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEREDASE 80UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CEREDASE 80UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CEREZYME INJ 200UNIT ![Compare how all Medicare Part D PDP plans in IN cover CEREZYME INJ 200UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CERUBIDINE 20MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover CERUBIDINE 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CESIA 7 DAYS X 3 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CESIA 7 DAYS X 3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHANTIX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHANTIX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:336 /168Days |
CHANTIX 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHANTIX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:336 /168Days |
CHANTIX STARTING MONTH PAK ![Compare how all Medicare Part D PDP plans in IN cover CHANTIX STARTING MONTH PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:336 /168Days |
CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH ![Compare how all Medicare Part D PDP plans in IN cover CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLOROQUINE PH 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLOROQUINE PH 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT) ![Compare how all Medicare Part D PDP plans in IN cover CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLOROTHIAZIDE 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLOROTHIAZIDE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLOROTHIAZIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLOROTHIAZIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROMAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROMAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROMAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROMAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROMAZINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROMAZINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROMAZINE 25MG/ML AMP ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROMAZINE 25MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROMAZINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROMAZINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROMAZINE HCL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROMAZINE HCL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROPAMIDE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROPAMIDE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORPROPAMIDE 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover CHLORPROPAMIDE 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORTHALIDONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CHLORTHALIDONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORTHALIDONE 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover CHLORTHALIDONE 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHLORZOXAZONE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CHLORZOXAZONE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in IN cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CICLOPIROX 0.77% CREAM ![Compare how all Medicare Part D PDP plans in IN cover CICLOPIROX 0.77% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CICLOPIROX 0.77% TOPICAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover CICLOPIROX 0.77% TOPICAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CICLOPIROX 8% TOPICAL SOLUTION NAIL LACQUER 6.6ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CICLOPIROX 8% TOPICAL SOLUTION NAIL LACQUER 6.6ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CILOSTAZOL 50MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in IN cover CILOSTAZOL 50MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CILOSTAZOL TABLET 100MG (60 CT) ![Compare how all Medicare Part D PDP plans in IN cover CILOSTAZOL TABLET 100MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CILOXAN SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CILOXAN SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CIMETIDINE 150MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CIMETIDINE 150MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIMETIDINE 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CIMETIDINE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIMETIDINE HCL 300MG/5ML SOL ![Compare how all Medicare Part D PDP plans in IN cover CIMETIDINE HCL 300MG/5ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIMETIDINE TABLETS ![Compare how all Medicare Part D PDP plans in IN cover CIMETIDINE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIMETIDINE TABLETS ![Compare how all Medicare Part D PDP plans in IN cover CIMETIDINE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIMETIDINE TABLETS USP ![Compare how all Medicare Part D PDP plans in IN cover CIMETIDINE TABLETS USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIMZIA 200 MG/ML SYRINGE KIT ![Compare how all Medicare Part D PDP plans in IN cover CIMZIA 200 MG/ML SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CIPRO 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CIPRO 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CIPRO 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CIPRO 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CIPRO 750MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CIPRO 750MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CIPRODEX OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover CIPRODEX OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CIPROFLOXACIN 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPROFLOXACIN 400 MG/40 ML VL ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN 400 MG/40 ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIPROFLOXACIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIPROFLOXACIN ER 1000MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN ER 1000MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIPROFLOXACIN ER 500MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN ER 500MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIPROFLOXACIN HCL 0.3% DROPS ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN HCL 0.3% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIPROFLOXACIN HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CIPROFLOXACIN TABLETS 750MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CIPROFLOXACIN TABLETS 750MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CISPLATIN 1 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CISPLATIN 1 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CITALOPRAM HBR 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CITALOPRAM HBR 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL ![Compare how all Medicare Part D PDP plans in IN cover CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in IN cover CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CITOLOPRAM HBR 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CITOLOPRAM HBR 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLADRIBINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CLADRIBINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CLAFORAN 500MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover CLAFORAN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLARAVIS 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLARAVIS 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARAVIS 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLARAVIS 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARAVIS 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLARAVIS 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARAVIS 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLARAVIS 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARINEX 0.5MG/ML SYRUP ![Compare how all Medicare Part D PDP plans in IN cover CLARINEX 0.5MG/ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | S |
CLARINEX 2.5MG REDITABS ![Compare how all Medicare Part D PDP plans in IN cover CLARINEX 2.5MG REDITABS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | S |
CLARINEX 5MG REDITABS ![Compare how all Medicare Part D PDP plans in IN cover CLARINEX 5MG REDITABS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | S |
CLARINEX 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLARINEX 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLARINEX-D 12 HOUR TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLARINEX-D 12 HOUR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | S |
CLARINEX-D 24 HOUR TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLARINEX-D 24 HOUR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | S |
CLARITHROMYCIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLARITHROMYCIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARITHROMYCIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLARITHROMYCIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARITHROMYCIN ER 500MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLARITHROMYCIN ER 500MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARITHROMYCIN FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover CLARITHROMYCIN FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLARITHROMYCIN FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover CLARITHROMYCIN FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLEMASTINE FUM 2.68MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLEMASTINE FUM 2.68MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLEMASTINE FUMARATE SYRUP ![Compare how all Medicare Part D PDP plans in IN cover CLEMASTINE FUMARATE SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLEOCIN 2% VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN 2% VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLEOCIN HCL 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN HCL 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLEOCIN HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLEOCIN HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CLEOCIN PHOS 150MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN PHOS 150MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLEOCIN T 1% GEL ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN T 1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLEOCIN T 1% LOTION ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN T 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLEOCIN T 1% PLEDGETS ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN T 1% PLEDGETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLEOCIN T 1% SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CLEOCIN T 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLIMARA 0.025MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA 0.025MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLIMARA 0.0375MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA 0.0375MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLIMARA 0.05MG/24H PATCH ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA 0.05MG/24H PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLIMARA 0.06/MG DAY PATCH ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA 0.06/MG DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLIMARA 0.075MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA 0.075MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLIMARA 0.1MG/24H PATCH ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA 0.1MG/24H PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CLIMARA PRO DIS WEEKLY 4.40MG/1.39MG ![Compare how all Medicare Part D PDP plans in IN cover CLIMARA PRO DIS WEEKLY 4.40MG/1.39MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CLINDAMYCIN HCL 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN HCL 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINDAMYCIN HYDROCHLORIDE CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN HYDROCHLORIDE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINDAMYCIN PHOSPHATE 1% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN PHOSPHATE 1% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINDAMYCIN PHOSPHATE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in IN cover CLINDAMYCIN PHOSPHATE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLINORIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLINORIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOBETASOL 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CLOBETASOL 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOBETASOL E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in IN cover CLOBETASOL E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOBETASOL PROPIONATE 0.05% FOAM ![Compare how all Medicare Part D PDP plans in IN cover CLOBETASOL PROPIONATE 0.05% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOLAR 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CLOLAR 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
CLOMIPRAMINE HCL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLOMIPRAMINE HCL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOMIPRAMINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLOMIPRAMINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOMIPRAMINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CLOMIPRAMINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLONIDINE HCL 0.2MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLONIDINE HCL 0.2MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLONIDINE HCL TABLET 0.1MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLONIDINE HCL TABLET 0.1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLONIDINE HCL TABLET 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLONIDINE HCL TABLET 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLONIDINE PATCH 0.1MG/DAY ![Compare how all Medicare Part D PDP plans in IN cover CLONIDINE PATCH 0.1MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLONIDINE PATCH 0.2MG/DAY ![Compare how all Medicare Part D PDP plans in IN cover CLONIDINE PATCH 0.2MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLONIDINE PATCH 0.3MG/DAY ![Compare how all Medicare Part D PDP plans in IN cover CLONIDINE PATCH 0.3MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in IN cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOTRIMAZOLE 10MG TROCHE ![Compare how all Medicare Part D PDP plans in IN cover CLOTRIMAZOLE 10MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL ![Compare how all Medicare Part D PDP plans in IN cover CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION ![Compare how all Medicare Part D PDP plans in IN cover CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE CREAM USP .5MG-10GM 45GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE CREAM USP .5MG-10GM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOZAPINE 100 MG DISINTEGRATING TABLET [FAZACLO] ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 100 MG DISINTEGRATING TABLET [FAZACLO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CLOZAPINE 100 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 100 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOZAPINE 12.5 MG DISINTEGRATING TABLET [FAZACLO] ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 12.5 MG DISINTEGRATING TABLET [FAZACLO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CLOZAPINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOZAPINE 25 MG DISINTEGRATING TABLET [FAZACLO] ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 25 MG DISINTEGRATING TABLET [FAZACLO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CLOZAPINE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOZAPINE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CLOZAPINE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CLOZARIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLOZARIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CLOZARIL 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CLOZARIL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CO-GESIC 5/500 TABLET ![Compare how all Medicare Part D PDP plans in IN cover CO-GESIC 5/500 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COLAZAL 750MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover COLAZAL 750MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COLCHICINE 0.6 MG ORAL TABLET [COLCRYS] ![Compare how all Medicare Part D PDP plans in IN cover COLCHICINE 0.6 MG ORAL TABLET [COLCRYS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COLESTID 1GM TABLET ![Compare how all Medicare Part D PDP plans in IN cover COLESTID 1GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COLESTID GRANULES ![Compare how all Medicare Part D PDP plans in IN cover COLESTID GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COLESTIPOL HCL 1G TABLET ![Compare how all Medicare Part D PDP plans in IN cover COLESTIPOL HCL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COLESTIPOL HCL 5G GRANULES ![Compare how all Medicare Part D PDP plans in IN cover COLESTIPOL HCL 5G GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COLISTIMETHATE 150MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover COLISTIMETHATE 150MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COLOCORT 100MG ENEMA ![Compare how all Medicare Part D PDP plans in IN cover COLOCORT 100MG ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COLYTE WITH FLAVOR PACKETS ![Compare how all Medicare Part D PDP plans in IN cover COLYTE WITH FLAVOR PACKETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COMBIPATCH 0.05/0.14MG PTCH ![Compare how all Medicare Part D PDP plans in IN cover COMBIPATCH 0.05/0.14MG PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COMBIPATCH 0.05/0.25MG PTCH ![Compare how all Medicare Part D PDP plans in IN cover COMBIPATCH 0.05/0.25MG PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COMBIVENT INHALER ![Compare how all Medicare Part D PDP plans in IN cover COMBIVENT INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COMBIVIR TABLETS ![Compare how all Medicare Part D PDP plans in IN cover COMBIVIR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COMPRO 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in IN cover COMPRO 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COMTAN 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COMTAN 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COMVAX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in IN cover COMVAX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | P |
CONCERTA ER TABLETS 18MG 100 TABLETS BOT ![Compare how all Medicare Part D PDP plans in IN cover CONCERTA ER TABLETS 18MG 100 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CONCERTA ER TABLETS 27MG 100 TABLETS BOT ![Compare how all Medicare Part D PDP plans in IN cover CONCERTA ER TABLETS 27MG 100 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CONCERTA ER TABLETS 36MG 100 TABLETS BOT ![Compare how all Medicare Part D PDP plans in IN cover CONCERTA ER TABLETS 36MG 100 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CONCERTA ER TABLETS 54MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CONCERTA ER TABLETS 54MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CONDYLOX TOPICAL SOLUTION .5% 3.5 ML CTR ![Compare how all Medicare Part D PDP plans in IN cover CONDYLOX TOPICAL SOLUTION .5% 3.5 ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CONSTULOSE 10GM/15ML SYRUP ![Compare how all Medicare Part D PDP plans in IN cover CONSTULOSE 10GM/15ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in IN cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
COPEGUS 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COPEGUS 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CORDARONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORDARONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COREG 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COREG 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COREG 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COREG 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COREG 3.125MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COREG 3.125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COREG 6.25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COREG 6.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COREG CR 10MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in IN cover COREG CR 10MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COREG CR 20MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in IN cover COREG CR 20MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COREG CR 40MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in IN cover COREG CR 40MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COREG CR 80MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in IN cover COREG CR 80MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CORGARD (NADOLOL) 80MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORGARD (NADOLOL) 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORGARD 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CORGARD 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CORGARD 40MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CORGARD 40MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORTEF 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORTEF 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORTEF 20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORTEF 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORTEF 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORTEF 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORTENEMA 100MG/60ML ENEMA ![Compare how all Medicare Part D PDP plans in IN cover CORTENEMA 100MG/60ML ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CORTISONE ACETATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CORTISONE ACETATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CORTISPORIN EAR SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CORTISPORIN EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORTOMYCIN EAR SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CORTOMYCIN EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CORTOMYCIN EAR SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover CORTOMYCIN EAR SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CORZIDE 40-5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORZIDE 40-5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CORZIDE 80-5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CORZIDE 80-5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COSMEGEN 0.5MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover COSMEGEN 0.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
COSOPT PLUS EYE DROPS 22.3 MG/ML 6.8 MG/M ![Compare how all Medicare Part D PDP plans in IN cover COSOPT PLUS EYE DROPS 22.3 MG/ML 6.8 MG/M.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
COUMADIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 3MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 4MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 5MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
COUMADIN 6MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COUMADIN 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover COUMADIN 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CRESTOR 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CRESTOR 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CRESTOR 20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CRESTOR 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CRESTOR 40MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CRESTOR 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CRESTOR 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CRESTOR 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CRIXIVAN 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CRIXIVAN 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CRIXIVAN 333MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CRIXIVAN 333MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CRIXIVAN 400MG CAPSULE (120 CT) ![Compare how all Medicare Part D PDP plans in IN cover CRIXIVAN 400MG CAPSULE (120 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CROMOLYN NEBULIZER SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover CROMOLYN NEBULIZER SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CUPRIMINE CAPSULES 250MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover CUPRIMINE CAPSULES 250MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CUTIVATE CREAM 0.05% ![Compare how all Medicare Part D PDP plans in IN cover CUTIVATE CREAM 0.05%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CUTIVATE LOTION 0.05% ![Compare how all Medicare Part D PDP plans in IN cover CUTIVATE LOTION 0.05%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
CUTIVATE OINTMENT 0.005% 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover CUTIVATE OINTMENT 0.005% 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYCLESSA 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in IN cover CYCLESSA 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYCLOBENZAPRINE HCL 5MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover CYCLOBENZAPRINE HCL 5MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYCLOPHOSPHAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CYCLOPHOSPHAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOPHOSPHAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CYCLOPHOSPHAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYCLOSPORINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYCLOSPORINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYCLOSPORINE 50MG/ML AMP ![Compare how all Medicare Part D PDP plans in IN cover CYCLOSPORINE 50MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in IN cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
CYKLOKAPRON 100MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IN cover CYKLOKAPRON 100MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CYMBALTA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYMBALTA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CYMBALTA 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYMBALTA 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in IN cover CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYPROHEPTADINE HCL 4 MG ![Compare how all Medicare Part D PDP plans in IN cover CYPROHEPTADINE HCL 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL ![Compare how all Medicare Part D PDP plans in IN cover CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYSTADANE POWDER FOR ORAL SOLUTION 180GM ![Compare how all Medicare Part D PDP plans in IN cover CYSTADANE POWDER FOR ORAL SOLUTION 180GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYTARABINE 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover CYTARABINE 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYTARABINE 500MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover CYTARABINE 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD ![Compare how all Medicare Part D PDP plans in IN cover CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
CYTOMEL 25MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CYTOMEL 25MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYTOMEL 50MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CYTOMEL 50MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYTOMEL 5MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover CYTOMEL 5MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYTOTEC TABLET 100MCG (120 CT) ![Compare how all Medicare Part D PDP plans in IN cover CYTOTEC TABLET 100MCG (120 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYTOTEC TABLET 200MCG (60 CT) ![Compare how all Medicare Part D PDP plans in IN cover CYTOTEC TABLET 200MCG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
CYTOVENE IV INJECTION ![Compare how all Medicare Part D PDP plans in IN cover CYTOVENE IV INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |