2011 Medicare Part D Plan Formulary Information |
CIGNA Medicare Rx Plan One (PDP) (S5617-008-0)
Benefit Details
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The CIGNA Medicare Rx Plan One (PDP) (S5617-008-0) Formulary Drugs Starting with the Letter R in CMS PDP Region 2 which includes: CT MA RI VT
|
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL ![Compare how all Medicare Part D PDP plans in VT cover RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RALOXIFENE 60 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in VT cover RALOXIFENE 60 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:30 /30Days |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RANEXA 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RANEXA 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RANEXA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RANEXA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RANITIDINE HCL 15MG/ML SYRUP ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE HCL 15MG/ML SYRUP.](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 |
RANITIDINE HCL 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE HCL 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RANITIDINE HCL 300MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE HCL 300MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RANITIDINE TABLET 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE TABLET 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RANITIDINE TABLET USP 150MG (500 CT) ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE TABLET USP 150MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RAPAFLO CAPSULES 4MG 30 BOT ![Compare how all Medicare Part D PDP plans in VT cover RAPAFLO CAPSULES 4MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | S Q:30 /30Days |
RAPAFLO CAPSULES 8MG 90 BOT ![Compare how all Medicare Part D PDP plans in VT cover RAPAFLO CAPSULES 8MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | S Q:30 /30Days |
RAPAMUNE 1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
RAPAMUNE 2MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
RAPAMUNE TABLETS ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | P |
REBETOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REBETOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REBETOL 40MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover REBETOL 40MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | S |
REBIF 22MCG/0.5ML SYRINGE ![Compare how all Medicare Part D PDP plans in VT cover REBIF 22MCG/0.5ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REBIF 44MCG/0.5ML SYRINGE ![Compare how all Medicare Part D PDP plans in VT cover REBIF 44MCG/0.5ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in VT cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in VT cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | P |
REGONOL AMP 10MG 5ML ![Compare how all Medicare Part D PDP plans in VT cover REGONOL AMP 10MG 5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | None |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in VT cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:30 /30Days |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in VT cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | Q:120 /365Days |
RELISTOR SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover RELISTOR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | P |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMICADE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REMODULIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REMODULIN 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REMODULIN 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REMODULIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
RENAGEL 400MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RENAGEL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RENAGEL 800MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RENAGEL 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RENAMIN 6.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover RENAMIN 6.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | P |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
REPREXAIN 5-200 MG TABLET 100 EA ![Compare how all Medicare Part D PDP plans in VT cover REPREXAIN 5-200 MG TABLET 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
REPREXAIN TABLET ![Compare how all Medicare Part D PDP plans in VT cover REPREXAIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
REPREXAIN TABLET ![Compare how all Medicare Part D PDP plans in VT cover REPREXAIN 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 |
REQUIP XL ROPINIROLE HCL 2MG ![Compare how all Medicare Part D PDP plans in VT cover REQUIP XL ROPINIROLE HCL 2MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
REQUIP XL ROPINIROLE HCL 4MG ![Compare how all Medicare Part D PDP plans in VT cover REQUIP XL ROPINIROLE HCL 4MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
REQUIP XL ROPINIROLE HCL 8MG ![Compare how all Medicare Part D PDP plans in VT cover REQUIP XL ROPINIROLE HCL 8MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
REQUIP XL TABLET 12 MG ![Compare how all Medicare Part D PDP plans in VT cover REQUIP XL TABLET 12 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RESCRIPTOR 100MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RESCRIPTOR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RESCRIPTOR 200MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RESCRIPTOR 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RESERPINE 0.1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RESERPINE 0.1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RESERPINE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RESERPINE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in VT cover RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RETAPAMULIN 0.01 MG/MG TOPICAL OINTMENT [ALTABAX] ![Compare how all Medicare Part D PDP plans in VT cover RETAPAMULIN 0.01 MG/MG TOPICAL OINTMENT [ALTABAX].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | None |
RETROVIR IV INFUSION VIAL ![Compare how all Medicare Part D PDP plans in VT cover RETROVIR IV INFUSION VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVATIO 10 MG/12.5 ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REVATIO 10 MG/12.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
REVATIO 20MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REVATIO 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REVIA 50MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REVIA 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | None |
REVLIMID 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REVLIMID 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REVLIMID 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
REYATAZ 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RHEUMATREX 2.5MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VT cover RHEUMATREX 2.5MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIBAPAK 400-400MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VT cover RIBAPAK 400-400MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
RIBAPAK 600-400MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VT cover RIBAPAK 600-400MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
RIBAPAK 600-600MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VT cover RIBAPAK 600-600MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIBASPHERE 400MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIBASPHERE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
RIBASPHERE 600MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIBASPHERE 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
RIBASPHERE CAPSULES 200MG 42 BOT ![Compare how all Medicare Part D PDP plans in VT cover RIBASPHERE CAPSULES 200MG 42 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIBAVIRIN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIBAVIRIN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in VT cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIBAVIRIN TABLETS 400MG 56 TABS BOT ![Compare how all Medicare Part D PDP plans in VT cover RIBAVIRIN TABLETS 400MG 56 TABS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIBAVIRIN TABLETS 600MG 56 TABS BOT ![Compare how all Medicare Part D PDP plans in VT cover RIBAVIRIN TABLETS 600MG 56 TABS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | S |
RIDAURA 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIDAURA 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIFAMATE CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIFAMATE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in VT cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RIFAMPIN 600MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover RIFAMPIN 600MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RIFATER TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIFATER TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | None |
RILUTEK 50MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RILUTEK 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RIMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
RINGERS INJECTION 1000ML BAG ![Compare how all Medicare Part D PDP plans in VT cover RINGERS INJECTION 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in VT cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VT cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | S |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | Q:4 /28Days |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | Q:4 /28Days |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | Q:4 /28Days |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | Q:4 /28Days |
RISPERIDONE 1 MG DISINTEGRATING TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE 1 MG DISINTEGRATING TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE ORAL SOLUTION 1MG 30 ML BOTDR ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE ORAL SOLUTION 1MG 30 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:240 /30Days |
RISPERIDONE TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE TABLET 1 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE TABLET 2 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE TABLET 3 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE TABLET 4 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:120 /30Days |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:120 /30Days |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RISPERIODONE TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERIODONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover RITUXAN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | Q:60 /30Days |
ROBAXIN 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover ROBAXIN 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$80.00 | $200.00 | P |
ROMYCIN 5MG/G OINTMENT ![Compare how all Medicare Part D PDP plans in VT cover ROMYCIN 5MG/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE 6 MG EXTENDED RELEASE TABLET 24 HR [REQUIP] ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE 6 MG EXTENDED RELEASE TABLET 24 HR [REQUIP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
ROPINIROLE HCL TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROPINIROLE HYDROCLORIDE TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HYDROCLORIDE 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 |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in VT cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$34.00 | $85.00 | None |
ROXICET 5-325/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VT cover ROXICET 5-325/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROXICET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROXICET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
ROXICET 5/500 CAPLET ![Compare how all Medicare Part D PDP plans in VT cover ROXICET 5/500 CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |