2011 Medicare Part D Plan Formulary Information |
Health Net Orange Option 1 (PDP) (S5678-036-0)
Sanctioned Plan
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The Health Net Orange Option 1 (PDP) (S5678-036-0) Formulary Drugs Starting with the Letter N in CMS PDP Region 15 which includes: IN KY
|
Drugs Starting with Letter N
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
NABUMETONE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NABUMETONE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NABUMETONE 750MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NABUMETONE 750MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NADOLOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NADOLOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NADOLOL 40MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NADOLOL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NADOLOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NADOLOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAFAZAIR 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover NAFAZAIR 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAFCILLIN 1GM/50ML INJ ![Compare how all Medicare Part D PDP plans in IN cover NAFCILLIN 1GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NAFCILLIN FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in IN cover NAFCILLIN FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NAFCILLIN FOR INJECTION 10GM/ML 1 VIAL ![Compare how all Medicare Part D PDP plans in IN cover NAFCILLIN FOR INJECTION 10GM/ML 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NAFTIN HCL GEL 1% 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover NAFTIN HCL GEL 1% 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NAFTIN 1% CREAM ![Compare how all Medicare Part D PDP plans in IN cover NAFTIN 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NAGLAZYME 5MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NAGLAZYME 5MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
NALBUPHINE 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NALBUPHINE 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NALBUPHINE 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NALBUPHINE 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NALFON 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NALFON 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NALLPEN 2GM/50ML 2.4% DEX ![Compare how all Medicare Part D PDP plans in IN cover NALLPEN 2GM/50ML 2.4% DEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NALOXONE 1MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover NALOXONE 1MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NALOXONE HCL INJECTION 0.4MG 10 X 1ML CTG ![Compare how all Medicare Part D PDP plans in IN cover NALOXONE HCL INJECTION 0.4MG 10 X 1ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NALTREXONE HCL 50MG TABLET 100 BLPK ![Compare how all Medicare Part D PDP plans in IN cover NALTREXONE HCL 50MG TABLET 100 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAMENDA 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NAMENDA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:2 /1Days |
NAMENDA 10MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover NAMENDA 10MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:10 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NAMENDA 5-10MG TITRATION PK ![Compare how all Medicare Part D PDP plans in IN cover NAMENDA 5-10MG TITRATION PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:2 /1Days |
NAMENDA 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NAMENDA 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:2 /1Days |
NAPRELAN 375MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NAPRELAN 375MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NAPRELAN CR 500MG TABLET 75 BOT ![Compare how all Medicare Part D PDP plans in IN cover NAPRELAN CR 500MG TABLET 75 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NAPROXEN 125MG/5ML SUSPEN ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN 125MG/5ML SUSPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAPROXEN 250 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN 250 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAPROXEN 375MG TABLET EC ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN 375MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAPROXEN 500MG TABLET EC ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN 500MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAPROXEN SODIUM 275 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN SODIUM 275 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAPROXEN SODIUM 550 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN SODIUM 550 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NAPROXEN TABLET 375MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover NAPROXEN TABLET 375MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NARDIL 15MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NARDIL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NASACORT AQ AER 55MCG/AC ![Compare how all Medicare Part D PDP plans in IN cover NASACORT AQ AER 55MCG/AC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:1 /1Days |
NASONEX 50MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in IN cover NASONEX 50MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:1 /1Days |
NATACYN EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover NATACYN EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NATEGLINIDE 120 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover NATEGLINIDE 120 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NATEGLINIDE 60 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover NATEGLINIDE 60 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NAVANE 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NAVANE 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NAVELBINE INJECTION 10MG/ML 5 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NAVELBINE INJECTION 10MG/ML 5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NEBUPENT 300MG INHAL POWDER ![Compare how all Medicare Part D PDP plans in IN cover NEBUPENT 300MG INHAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NECON 0.5/35-28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover NECON 0.5/35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
NECON 1/35-28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover NECON 1/35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NECON 10/11-28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover NECON 10/11-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:1 /1Days |
NECON 7 DAYS X 3 TABLET ![Compare how all Medicare Part D PDP plans in IN cover NECON 7 DAYS X 3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
NEFAZODONE HCL 150MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in IN cover NEFAZODONE HCL 150MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:4 /1Days |
NEFAZODONE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NEFAZODONE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:2 /1Days |
NEFAZODONE HCL 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NEFAZODONE HCL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:2 /1Days |
NEFAZODONE HYDROCHLORIDE TABLETS 100MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover NEFAZODONE HYDROCHLORIDE TABLETS 100MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:2 /1Days |
NEFAZODONE HYDROCHLORIDE TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover NEFAZODONE HYDROCHLORIDE TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:3 /1Days |
NEO-FRADIN 125MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in IN cover NEO-FRADIN 125MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NEO/POLY/DEX OIN 0.1% OP ![Compare how all Medicare Part D PDP plans in IN cover NEO/POLY/DEX OIN 0.1% OP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEO/POLYMYXIN/HC EAR TUBEX 10MG/3.5MG/100UNT ![Compare how all Medicare Part D PDP plans in IN cover NEO/POLYMYXIN/HC EAR TUBEX 10MG/3.5MG/100UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEOMYCIN AND POLYMYXIN B SULFATES SOLUTION FOR IRRIGATION 40MG/20000UNT ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN AND POLYMYXIN B SULFATES SOLUTION FOR IRRIGATION 40MG/20000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NEOMYCIN SULFATE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN SULFATE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEOMYCIN-BACITRACIN-POLY-HC 3.5-10K-1 OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN-BACITRACIN-POLY-HC 3.5-10K-1 OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEOMYCIN-POLYMYXIN-HC 3.5-10K-10 SUSPENSION DROPS ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN-POLYMYXIN-HC 3.5-10K-10 SUSPENSION DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEOMYCIN/POLYMY/DEXA EYE DROPS 3.5MG/1ML ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN/POLYMY/DEXA EYE DROPS 3.5MG/1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEOMYCIN/POLYMY/HYDRO OTIC SUS ![Compare how all Medicare Part D PDP plans in IN cover NEOMYCIN/POLYMY/HYDRO OTIC SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NEPHRAMINE SOLUTION FOR INJECTION ![Compare how all Medicare Part D PDP plans in IN cover NEPHRAMINE SOLUTION FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | P |
NEULASTA 6MG/0.6ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover NEULASTA 6MG/0.6ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NEUPOGEN 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NEUPOGEN 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NEUPOGEN INJECTION 300MCG/0.5ML 0.5ML SYR ![Compare how all Medicare Part D PDP plans in IN cover NEUPOGEN INJECTION 300MCG/0.5ML 0.5ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NEUPOGEN INJECTION 480MCG/0.8ML 10 X 0.8ML SYR ![Compare how all Medicare Part D PDP plans in IN cover NEUPOGEN INJECTION 480MCG/0.8ML 10 X 0.8ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NEURONTIN 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NEURONTIN 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NEURONTIN 250MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover NEURONTIN 250MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NEURONTIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NEURONTIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NEURONTIN 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NEURONTIN 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NEURONTIN 600MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NEURONTIN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NEURONTIN 800MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NEURONTIN 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NEVANAC 0.1% DROPTAINER ![Compare how all Medicare Part D PDP plans in IN cover NEVANAC 0.1% DROPTAINER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:3 /14Days |
NEXAVAR TABLETS 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in IN cover NEXAVAR TABLETS 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NEXIUM IV 20MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover NEXIUM IV 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NEXIUM IV 40MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover NEXIUM IV 40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NEXT CHOICE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NEXT CHOICE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NIACOR 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NIACOR 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIASPAN 1000MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IN cover NIASPAN 1000MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NIASPAN ER 500MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IN cover NIASPAN ER 500MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NIASPAN ER 750MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IN cover NIASPAN ER 750MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NICARDIPINE HCL INJECTION 25MG/10ML 10 X 10ML CRTN ![Compare how all Medicare Part D PDP plans in IN cover NICARDIPINE HCL INJECTION 25MG/10ML 10 X 10ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NICARDIPINE HYDROCHLORIDE CAPSULES 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover NICARDIPINE HYDROCHLORIDE CAPSULES 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NICARDIPINE HYDROCHLORIDE CAPSULES 30MG 500 BOT ![Compare how all Medicare Part D PDP plans in IN cover NICARDIPINE HYDROCHLORIDE CAPSULES 30MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NICOTROL INHALER 10MG 168 X 10MG/CARTRIDGE INHL ![Compare how all Medicare Part D PDP plans in IN cover NICOTROL INHALER 10MG 168 X 10MG/CARTRIDGE INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | P |
NICOTROL NS NASAL SPRAY BOTTLE 10MG 4 X 10MG/ML INHL ![Compare how all Medicare Part D PDP plans in IN cover NICOTROL NS NASAL SPRAY BOTTLE 10MG 4 X 10MG/ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | P |
NIFEDIAC CC 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIAC CC 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NIFEDIAC CC 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIAC CC 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NIFEDIAC CC 90MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIAC CC 90MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NIFEDICAL XL 30MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in IN cover NIFEDICAL XL 30MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIFEDICAL XL 60MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in IN cover NIFEDICAL XL 60MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIFEDIPINE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIPINE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIFEDIPINE 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIPINE 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIFEDIPINE ER 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIPINE ER 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIFEDIPINE ER 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIPINE ER 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIFEDIPINE ER 90MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover NIFEDIPINE ER 90MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NILANDRON 150MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NILANDRON 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NIMODIPINE 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NIMODIPINE 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NIPENT FOR INJECTION 10MG VIALS ![Compare how all Medicare Part D PDP plans in IN cover NIPENT FOR INJECTION 10MG VIALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NITRO BID OINTMENT 2% 1 GRAM X 48 PKG ![Compare how all Medicare Part D PDP plans in IN cover NITRO BID OINTMENT 2% 1 GRAM X 48 PKG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NITRO-DUR 0.3MG/HR PATCH ![Compare how all Medicare Part D PDP plans in IN cover NITRO-DUR 0.3MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:1 /1Days |
NITRO-DUR 0.8MG/HR PATCH INST. ![Compare how all Medicare Part D PDP plans in IN cover NITRO-DUR 0.8MG/HR PATCH INST..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | Q:1 /1Days |
NITROFURANTOIN 100MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover NITROFURANTOIN 100MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NITROFURANTOIN MCR 50MG CAP ![Compare how all Medicare Part D PDP plans in IN cover NITROFURANTOIN MCR 50MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NITROGLYCERIN .2MG/HR PATCH ![Compare how all Medicare Part D PDP plans in IN cover NITROGLYCERIN .2MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NITROGLYCERIN .4MG/HR PATCH ![Compare how all Medicare Part D PDP plans in IN cover NITROGLYCERIN .4MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NITROGLYCERIN .6MG/HR PATCH ![Compare how all Medicare Part D PDP plans in IN cover NITROGLYCERIN .6MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NITROGLYCERIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NITROGLYCERIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NITROGLYCERIN TRANSOERMAL SYSTEM .1MG/HR 30 SYSTEM BOX ![Compare how all Medicare Part D PDP plans in IN cover NITROGLYCERIN TRANSOERMAL SYSTEM .1MG/HR 30 SYSTEM BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NITROLINGUAL SPR PUMPSPRA ![Compare how all Medicare Part D PDP plans in IN cover NITROLINGUAL SPR PUMPSPRA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NITROSTAT 0.3MG TABLET SL ![Compare how all Medicare Part D PDP plans in IN cover NITROSTAT 0.3MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NITROSTAT 0.4MG TABLET SL ![Compare how all Medicare Part D PDP plans in IN cover NITROSTAT 0.4MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NITROSTAT 0.6MG TABLET SL ![Compare how all Medicare Part D PDP plans in IN cover NITROSTAT 0.6MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NIZATIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NIZATIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NIZATIDINE 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NIZATIDINE 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NIZATIDINE ORAL SOLUTION 15MG/ML ![Compare how all Medicare Part D PDP plans in IN cover NIZATIDINE ORAL SOLUTION 15MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NORA-BE 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NORA-BE 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
NORDITROPIN 15MG/1.5ML CRTG ![Compare how all Medicare Part D PDP plans in IN cover NORDITROPIN 15MG/1.5ML CRTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NORDITROPIN 5MG/1.5ML CRTG ![Compare how all Medicare Part D PDP plans in IN cover NORDITROPIN 5MG/1.5ML CRTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NORDITROPIN NORDIFLEX 10MG/1.5 ![Compare how all Medicare Part D PDP plans in IN cover NORDITROPIN NORDIFLEX 10MG/1.5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NORETHINDRONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NORETHINDRONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NORFLEX 30MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IN cover NORFLEX 30MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NORITATE 1% CREAM ![Compare how all Medicare Part D PDP plans in IN cover NORITATE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NORMOSOL -R INJ /D5W ![Compare how all Medicare Part D PDP plans in IN cover NORMOSOL -R INJ /D5W.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | P |
NORMOSOL-M AND DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in IN cover NORMOSOL-M AND DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | P |
NORMOSOL-R PH 7.4 IV SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover NORMOSOL-R PH 7.4 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | P |
NOROXIN 400MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NOROXIN 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NORPACE CR 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover NORPACE CR 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NORTREL 0.5-0.035 TABLET ![Compare how all Medicare Part D PDP plans in IN cover NORTREL 0.5-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
NORTREL 1-0.035MG TABLET 21DAY ![Compare how all Medicare Part D PDP plans in IN cover NORTREL 1-0.035MG TABLET 21DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
NORTREL 1-0.035MG TABLET 28DAY ![Compare how all Medicare Part D PDP plans in IN cover NORTREL 1-0.035MG TABLET 28DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
NORTREL 7 DAYS X 3 TABLET ![Compare how all Medicare Part D PDP plans in IN cover NORTREL 7 DAYS X 3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NORTRIPTYLINE 10MG/5ML SOL ![Compare how all Medicare Part D PDP plans in IN cover NORTRIPTYLINE 10MG/5ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NORTRIPTYLINE HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NORTRIPTYLINE HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NORTRIPTYLINE HCL 25MG CAP ![Compare how all Medicare Part D PDP plans in IN cover NORTRIPTYLINE HCL 25MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NORTRIPTYLINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NORTRIPTYLINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NORTRIPTYLINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover NORTRIPTYLINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NORVIR 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover NORVIR 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NORVIR 100MG SOFTGEL CAP ![Compare how all Medicare Part D PDP plans in IN cover NORVIR 100MG SOFTGEL CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | None |
NORVIR 80MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover NORVIR 80MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
NOVAMINE 15% 500ML IV ![Compare how all Medicare Part D PDP plans in IN cover NOVAMINE 15% 500ML IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | P |
NOVANTRONE 2MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NOVANTRONE 2MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | None |
NOVAREL INJ 10000UNT ![Compare how all Medicare Part D PDP plans in IN cover NOVAREL INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NOVOLIN 70/30 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NOVOLIN 70/30 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:2 /1Days |
NOVOLIN 70/INJ 30 INNLT ![Compare how all Medicare Part D PDP plans in IN cover NOVOLIN 70/INJ 30 INNLT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | P Q:2 /1Days |
NOVOLIN N 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NOVOLIN N 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:2 /1Days |
NOVOLIN N INJ INNOLET ![Compare how all Medicare Part D PDP plans in IN cover NOVOLIN N INJ INNOLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | P Q:2 /1Days |
NOVOLIN R 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NOVOLIN R 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:1 /1Days |
NOVOLOG 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover NOVOLOG 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:2 /1Days |
NOVOLOG FLEXPEN SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover NOVOLOG FLEXPEN SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | P Q:2 /1Days |
NOVOLOG MIX 70/30 SYRINGE 70-30U/ML ![Compare how all Medicare Part D PDP plans in IN cover NOVOLOG MIX 70/30 SYRINGE 70-30U/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | P Q:1 /1Days |
NOVOLOG MIX 70/30 VIAL ![Compare how all Medicare Part D PDP plans in IN cover NOVOLOG MIX 70/30 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$75.00 | $188.00 | Q:1 /1Days |
NOXAFIL 200MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in IN cover NOXAFIL 200MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NUTROPIN 10MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover NUTROPIN 10MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NUTROPIN AQ 20MG/2ML PEN CART SOMATROPIN ![Compare how all Medicare Part D PDP plans in IN cover NUTROPIN AQ 20MG/2ML PEN CART SOMATROPIN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NUTROPIN AQ INJ 10MG/2ML ![Compare how all Medicare Part D PDP plans in IN cover NUTROPIN AQ INJ 10MG/2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NUTROPIN AQ PEN CARTRIDGE 10MG/2 ML ![Compare how all Medicare Part D PDP plans in IN cover NUTROPIN AQ PEN CARTRIDGE 10MG/2 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NUTROPIN SOMATROPIN RDNAORIGIN FOR INJECTION 5MG 1 VIAL ![Compare how all Medicare Part D PDP plans in IN cover NUTROPIN SOMATROPIN RDNAORIGIN FOR INJECTION 5MG 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
NUVARING 0.12-0.015 RING VAGINAL ![Compare how all Medicare Part D PDP plans in IN cover NUVARING 0.12-0.015 RING VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$34.00 | $68.00 | None |
NYAMYC 100000 U/G POWDER ![Compare how all Medicare Part D PDP plans in IN cover NYAMYC 100000 U/G POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTATIN 100000 UNT/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN 100000 UNT/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTATIN 100000U/G POWDER ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN 100000U/G POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTATIN 100000U/GM CREAM ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN 100000U/GM CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTATIN OINTMENT 100000UNT/GM 15 GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN OINTMENT 100000UNT/GM 15 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTATIN TABLET 500000U (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN TABLET 500000U (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NYSTATIN/TRIAMCINOLONE CRM ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN/TRIAMCINOLONE CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTATIN/TRIAMCINOLONE OINT 10000UNT/1MG ![Compare how all Medicare Part D PDP plans in IN cover NYSTATIN/TRIAMCINOLONE OINT 10000UNT/1MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |
NYSTOP 100000U/GM POWDER ![Compare how all Medicare Part D PDP plans in IN cover NYSTOP 100000U/GM POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $8.00 | None |