2011 Medicare Part D Plan Formulary Information |
CIGNA Medicare Rx Plan One (PDP) (S5617-123-0)
Benefit Details
![Email Prescription and/or Health Benefit details for CIGNA Medicare Rx Plan One (PDP). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The CIGNA Medicare Rx Plan One (PDP) (S5617-123-0) Formulary Drugs Starting with the Letter F in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FABRAZYME 35MG VIAL ![Compare how all Medicare Part D PDP plans in WY cover FABRAZYME 35MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
FACTIVE 320MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FACTIVE 320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | Q:30 /30Days |
FAMOTIDINE 20MG PIGGYBACK ![Compare how all Medicare Part D PDP plans in WY cover FAMOTIDINE 20MG PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FAMOTIDINE 20MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WY cover FAMOTIDINE 20MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FAMOTIDINE 40MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FAMOTIDINE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD ![Compare how all Medicare Part D PDP plans in WY cover FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FARESTON 60MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FARESTON 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FASLODEX INJECTION ![Compare how all Medicare Part D PDP plans in WY cover FASLODEX INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
FAZACLO TABLETS ORALLY DISINTEGRATING ![Compare how all Medicare Part D PDP plans in WY cover FAZACLO TABLETS ORALLY DISINTEGRATING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FELBATOL 400MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FELBATOL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELBATOL 600MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FELBATOL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FELBATOL 600MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WY cover FELBATOL 600MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FELODIPINE ER 2.5MG TABLET 90 TABLET BOT ![Compare how all Medicare Part D PDP plans in WY cover FELODIPINE ER 2.5MG TABLET 90 TABLET BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | S Q:30 /30Days |
FELODIPINE TABLET ER 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WY cover FELODIPINE TABLET ER 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | S Q:30 /30Days |
FELODIPINE TABLET ER 5MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WY cover FELODIPINE TABLET ER 5MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | S Q:30 /30Days |
FEMARA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FEMARA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FENOFIBRATE 134MG CAPSULE ![Compare how all Medicare Part D PDP plans in WY cover FENOFIBRATE 134MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:30 /30Days |
FENOFIBRATE 160MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FENOFIBRATE 160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:30 /30Days |
FENOFIBRATE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WY cover FENOFIBRATE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:30 /30Days |
FENOFIBRATE 54MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FENOFIBRATE 54MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:60 /30Days |
FENOFIBRATE 67MG CAPSULE ![Compare how all Medicare Part D PDP plans in WY cover FENOFIBRATE 67MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOPROFEN 600MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FENOPROFEN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FENTANYL 0.2 MG BUCCAL FILM [ONSOLIS] ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 0.2 MG BUCCAL FILM [ONSOLIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL 0.4 MG BUCCAL FILM [ONSOLIS] ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 0.4 MG BUCCAL FILM [ONSOLIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL 0.6 MG BUCCAL FILM [ONSOLIS] ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 0.6 MG BUCCAL FILM [ONSOLIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL 0.8 MG BUCCAL FILM [ONSOLIS] ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 0.8 MG BUCCAL FILM [ONSOLIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL 1.2 MG BUCCAL FILM [ONSOLIS] ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 1.2 MG BUCCAL FILM [ONSOLIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:20 /30Days |
FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:20 /30Days |
FENTANYL CITRATE INJECTION 50MCG 10 X 2ML CTG ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE INJECTION 50MCG 10 X 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE OTFC 200 MCG ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL CITRATE OTFC 200 MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:20 /30Days |
FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:20 /30Days |
FENTANYL TRANSDERMAL SYSTEM 75MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in WY cover FENTANYL TRANSDERMAL SYSTEM 75MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:20 /30Days |
FEXOFENADINE HCL 180MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FEXOFENADINE HCL 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:30 /30Days |
FEXOFENADINE HCL 30MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FEXOFENADINE HCL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:60 /30Days |
FEXOFENADINE HCL 60MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FEXOFENADINE HCL 60MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | Q:60 /30Days |
FINASTERIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FINASTERIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLAREX 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in WY cover FLAREX 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FLAVOXATE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLAVOXATE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLECAINIDE ACETATE 100 MG TAB #60 EA ![Compare how all Medicare Part D PDP plans in WY cover FLECAINIDE ACETATE 100 MG TAB #60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLECAINIDE ACETATE 150 MG TAB 360 EA ![Compare how all Medicare Part D PDP plans in WY cover FLECAINIDE ACETATE 150 MG TAB 360 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLECAINIDE ACETATE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLECAINIDE ACETATE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLECTOR PATCH ![Compare how all Medicare Part D PDP plans in WY cover FLECTOR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FLOVENT DISKUS /BLIST AEPB ![Compare how all Medicare Part D PDP plans in WY cover FLOVENT DISKUS /BLIST AEPB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLOVENT DISKUS /BLIST AEPB ![Compare how all Medicare Part D PDP plans in WY cover FLOVENT DISKUS /BLIST AEPB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in WY cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLOVENT HFA 110MCG INHALATION AEROSOL ![Compare how all Medicare Part D PDP plans in WY cover FLOVENT HFA 110MCG INHALATION AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLOVENT HFA 220MCG INHALATION AEROSOL ![Compare how all Medicare Part D PDP plans in WY cover FLOVENT HFA 220MCG INHALATION AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT HFA 44MCG INHALATION AEROSOL ![Compare how all Medicare Part D PDP plans in WY cover FLOVENT HFA 44MCG INHALATION AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLUCONAZOLE 200MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE 200MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUCONAZOLE 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
FLUCONAZOLE ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUCONAZOLE ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUCONAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUCONAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in WY cover FLUCONAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUDARA 50MG VIAL ![Compare how all Medicare Part D PDP plans in WY cover FLUDARA 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
FLUDARABINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in WY cover FLUDARABINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUMADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUMADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in WY cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINOLONE 0.01% CREAM ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINOLONE 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINOLONE 0.01% SOLUTION ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINOLONE 0.01% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINOLONE 0.025% CREAM ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINOLONE 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINOLONE 0.025% OINTMENT ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINOLONE 0.025% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINONIDE 0.05% GEL ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINONIDE 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINONIDE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINONIDE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOCINONIDE EMOLLIENT 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WY cover FLUOCINONIDE EMOLLIENT 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOROMETHOLONE 0.1% DROPS ![Compare how all Medicare Part D PDP plans in WY cover FLUOROMETHOLONE 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOROURACIL 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in WY cover FLUOROURACIL 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLUOROURACIL 5% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in WY cover FLUOROURACIL 5% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLUOROURACIL CREA 5% ![Compare how all Medicare Part D PDP plans in WY cover FLUOROURACIL CREA 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FLUOROURACIL INJECTION 50MG/ML 10 X 10 ML VIALGL ![Compare how all Medicare Part D PDP plans in WY cover FLUOROURACIL INJECTION 50MG/ML 10 X 10 ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | P |
FLUOXETINE 20 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in WY cover FLUOXETINE 20 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOXETINE 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in WY cover FLUOXETINE 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOXETINE 40MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLUOXETINE 40MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOXETINE CAPSULES 10MG (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLUOXETINE CAPSULES 10MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOXETINE HCL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUOXETINE HCL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT ![Compare how all Medicare Part D PDP plans in WY cover FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE DECANOATE INJECTION USP 25MG 1 X 5ML VIAL ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE DECANOATE INJECTION USP 25MG 1 X 5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR ![Compare how all Medicare Part D PDP plans in WY cover FLUPHENAZINE HCL 2.5MG/5ML ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLURBIPROFEN 0.03% EYE DROP ![Compare how all Medicare Part D PDP plans in WY cover FLURBIPROFEN 0.03% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLURBIPROFEN 100MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLURBIPROFEN 100MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLURBIPROFEN 50MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLURBIPROFEN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUTAMIDE 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in WY cover FLUTAMIDE 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUTICASONE PROPIONATE 0.005% OINTMENT ![Compare how all Medicare Part D PDP plans in WY cover FLUTICASONE PROPIONATE 0.005% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUTICASONE PROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WY cover FLUTICASONE PROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in WY cover FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUVOXAMINE MALEATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUVOXAMINE MALEATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUVOXAMINE MALEATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FLUVOXAMINE MALEATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FLUVOXAMINE MALEATE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FLUVOXAMINE MALEATE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOMEPIZOLE INJECTION 1GM/ML ![Compare how all Medicare Part D PDP plans in WY cover FOMEPIZOLE INJECTION 1GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
FORADIL AEROLIZER 12 MCG CAP ![Compare how all Medicare Part D PDP plans in WY cover FORADIL AEROLIZER 12 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FORTEO INJECTION ![Compare how all Medicare Part D PDP plans in WY cover FORTEO INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in WY cover FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FOSAMAX 70MG ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in WY cover FOSAMAX 70MG ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | Q:300 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSCARNET 24MG/ML INFUS BTTL ![Compare how all Medicare Part D PDP plans in WY cover FOSCARNET 24MG/ML INFUS BTTL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | P |
FOSINOPRIL SODIUM 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WY cover FOSINOPRIL SODIUM 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOSINOPRIL SODIUM 20MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FOSINOPRIL SODIUM 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOSINOPRIL SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FOSINOPRIL SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WY cover FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOSPHEN SDV 50MGPE/ML 2MLGEN10 50MG PE/ML VIAL ![Compare how all Medicare Part D PDP plans in WY cover FOSPHEN SDV 50MGPE/ML 2MLGEN10 50MG PE/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FOSRENOL 1000MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WY cover FOSRENOL 1000MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FOSRENOL 500MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WY cover FOSRENOL 500MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FOSRENOL 750MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WY cover FOSRENOL 750MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1 ![Compare how all Medicare Part D PDP plans in WY cover FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S Q:133 /365Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FRAGMIN 2500UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in WY cover FRAGMIN 2500UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | S Q:6 /365Days |
FRAGMIN 5000UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in WY cover FRAGMIN 5000UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$84.00 | $210.00 | S Q:6 /365Days |
FRAGMIN INJECTION 10000UNITS 1 X 10 SYR ![Compare how all Medicare Part D PDP plans in WY cover FRAGMIN INJECTION 10000UNITS 1 X 10 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S Q:180 /365Days |
FRAGMIN INJECTION 7500UNT/ML ![Compare how all Medicare Part D PDP plans in WY cover FRAGMIN INJECTION 7500UNT/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S Q:54 /365Days |
FREAMINE HBC INJECTION ![Compare how all Medicare Part D PDP plans in WY cover FREAMINE HBC INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | P |
FREAMINE III INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in WY cover FREAMINE III INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | P |
FREAMINE III INJECTION WITH ELECTROLYTES 3% ![Compare how all Medicare Part D PDP plans in WY cover FREAMINE III INJECTION WITH ELECTROLYTES 3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | P |
FURADANTIN 25 MG/5 ML SUSP 230 ML ![Compare how all Medicare Part D PDP plans in WY cover FURADANTIN 25 MG/5 ML SUSP 230 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$28.00 | $70.00 | None |
FUROSEMIDE 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WY cover FUROSEMIDE 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FUROSEMIDE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WY cover FUROSEMIDE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FUROSEMIDE 40MG TABLET ![Compare how all Medicare Part D PDP plans in WY cover FUROSEMIDE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in WY cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FUROSEMIDE 80MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WY cover FUROSEMIDE 80MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FUROSEMIDE INJECTION USP 10MG 25 X 4ML VIALSD ![Compare how all Medicare Part D PDP plans in WY cover FUROSEMIDE INJECTION USP 10MG 25 X 4ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
FUZEON CONVENIENCE KIT ![Compare how all Medicare Part D PDP plans in WY cover FUZEON CONVENIENCE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |