2011 Medicare Part D Plan Formulary Information |
AARP MedicareRx Enhanced (PDP) (S5921-249-0)
Benefit Details
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The AARP MedicareRx Enhanced (PDP) (S5921-249-0) Formulary Drugs Starting with the Letter I in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter I
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
IBUPROFEN 100MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in IA cover IBUPROFEN 100MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IBUPROFEN 600 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IA cover IBUPROFEN 600 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IBUPROFEN 800 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover IBUPROFEN 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IBUPROFEN TABLETS ![Compare how all Medicare Part D PDP plans in IA cover IBUPROFEN TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IDAMYCIN PFS 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover IDAMYCIN PFS 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | S |
IDARUBICIN HCL 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover IDARUBICIN HCL 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
IFEX INJECTION 3GM/ML 3GM VIALSD ![Compare how all Medicare Part D PDP plans in IA cover IFEX INJECTION 3GM/ML 3GM VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IFOSFAMIDE FOR INFECTION 1 GM ![Compare how all Medicare Part D PDP plans in IA cover IFOSFAMIDE FOR INFECTION 1 GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IFOSFAMIDE/MESNA KIT 1G/20ML / 1MG/ ![Compare how all Medicare Part D PDP plans in IA cover IFOSFAMIDE/MESNA KIT 1G/20ML / 1MG/.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
IFOSFAMIDE/MESNA KIT 1G/20ML / 1MG/ ![Compare how all Medicare Part D PDP plans in IA cover IFOSFAMIDE/MESNA KIT 1G/20ML / 1MG/.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ILOPERIDONE 1 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 1 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
ILOPERIDONE 10 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 10 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
ILOPERIDONE 12 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 12 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
ILOPERIDONE 2 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 2 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
ILOPERIDONE 4 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 4 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
ILOPERIDONE 6 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 6 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
ILOPERIDONE 8 MG ORAL TABLET [FANAPT] ![Compare how all Medicare Part D PDP plans in IA cover ILOPERIDONE 8 MG ORAL TABLET [FANAPT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S Q:62 /31Days |
IMDUR 120MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover IMDUR 120MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IMDUR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover IMDUR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IMDUR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover IMDUR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IMIPRAMINE HCL 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE HCL 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMIPRAMINE HCL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE HCL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IMIPRAMINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IMIPRAMINE PAMOATE CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE PAMOATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IMIPRAMINE PAMOATE CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE PAMOATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IMIPRAMINE PAMOATE CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE PAMOATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IMIPRAMINE PAMOATE CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover IMIPRAMINE PAMOATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IMIQUIMOD 5% CREAM ![Compare how all Medicare Part D PDP plans in IA cover IMIQUIMOD 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IMITREX 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:9 /30Days |
IMITREX 20MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 20MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:6 /30Days |
IMITREX 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:9 /30Days |
IMITREX 4MG/0.5ML KIT REFILL ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 4MG/0.5ML KIT REFILL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:4 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMITREX 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:9 /30Days |
IMITREX 5MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 5MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:6 /30Days |
IMITREX 6MG/0.5ML SYRNG KIT ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 6MG/0.5ML SYRNG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:4 /30Days |
IMITREX 6MG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover IMITREX 6MG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | Q:4 /30Days |
IMOVAX RABIES VACCINE 2.5UNT/ML ![Compare how all Medicare Part D PDP plans in IA cover IMOVAX RABIES VACCINE 2.5UNT/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IMURAN 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover IMURAN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INCRELEX 40MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover INCRELEX 40MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
INDAPAMIDE 1.25MG TABLET USP (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover INDAPAMIDE 1.25MG TABLET USP (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
INDAPAMIDE 2.5MG TABLET USP (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover INDAPAMIDE 2.5MG TABLET USP (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
INDERAL LA LONG ACTING CAPSULES 120MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover INDERAL LA LONG ACTING CAPSULES 120MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INDERAL LA LONG ACTING CAPSULES 160MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover INDERAL LA LONG ACTING CAPSULES 160MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INDERAL LA LONG ACTING CAPSULES 60MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover INDERAL LA LONG ACTING CAPSULES 60MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INDERAL LA LONG ACTING CAPSULES 80MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover INDERAL LA LONG ACTING CAPSULES 80MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INDOCIN ORAL SUSPENSION 25MG/5ML 237 ML BOT ![Compare how all Medicare Part D PDP plans in IA cover INDOCIN ORAL SUSPENSION 25MG/5ML 237 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INDOMETHACIN 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover INDOMETHACIN 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
INDOMETHACIN 75MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IA cover INDOMETHACIN 75MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
INDOMETHACIN CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover INDOMETHACIN CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
INFERGEN INJECTION ![Compare how all Medicare Part D PDP plans in IA cover INFERGEN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
INFUMORPH 10MG/ML AMPUL P/F ![Compare how all Medicare Part D PDP plans in IA cover INFUMORPH 10MG/ML AMPUL P/F.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INFUMORPH 25MG/ML AMPUL P/F ![Compare how all Medicare Part D PDP plans in IA cover INFUMORPH 25MG/ML AMPUL P/F.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INNOPRAN CAPSULES EXTENDED RELEASE 120 MG ![Compare how all Medicare Part D PDP plans in IA cover INNOPRAN CAPSULES EXTENDED RELEASE 120 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INNOPRAN CAPSULES EXTENDED RELEASE 80 MG ![Compare how all Medicare Part D PDP plans in IA cover INNOPRAN CAPSULES EXTENDED RELEASE 80 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INSPRA 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover INSPRA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INSPRA 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover INSPRA 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INSULIN, GLULISINE, HUMAN 100 UNT/ML PREFILLED SYRINGE [APIDRA] 3 ML ![Compare how all Medicare Part D PDP plans in IA cover INSULIN, GLULISINE, HUMAN 100 UNT/ML PREFILLED SYRINGE [APIDRA] 3 ML .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
INTELENCE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover INTELENCE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
INTERFERON BETA-1B 0.25 MG/ML INJECTABLE SOLUTION [EXTAVIA] ![Compare how all Medicare Part D PDP plans in IA cover INTERFERON BETA-1B 0.25 MG/ML INJECTABLE SOLUTION [EXTAVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P Q:15 /30Days |
INTRALIPID 20% IV FAT EMUL ![Compare how all Medicare Part D PDP plans in IA cover INTRALIPID 20% IV FAT EMUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | P |
INTRALIPID PHARMACY BULK PACKAGE FAT EMULSION 1.7-1.2-30GM 500ML BAG ![Compare how all Medicare Part D PDP plans in IA cover INTRALIPID PHARMACY BULK PACKAGE FAT EMULSION 1.7-1.2-30GM 500ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | P |
INTRON A 10MMU INJ PEN ![Compare how all Medicare Part D PDP plans in IA cover INTRON A 10MMU INJ PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
INTRON A 10MMU VIAL ![Compare how all Medicare Part D PDP plans in IA cover INTRON A 10MMU VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
INTRON A 3MMU INJECTION PEN ![Compare how all Medicare Part D PDP plans in IA cover INTRON A 3MMU INJECTION PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | P Q:6 /28Days |
INTRON A 5MMU MULTIDOSE PEN ![Compare how all Medicare Part D PDP plans in IA cover INTRON A 5MMU MULTIDOSE PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INTRON A 6MMU/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover INTRON A 6MMU/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
INVANZ 1GM VIAL ![Compare how all Medicare Part D PDP plans in IA cover INVANZ 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
INVEGA 3MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in IA cover INVEGA 3MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S |
INVEGA 6MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in IA cover INVEGA 6MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S |
INVEGA 9MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in IA cover INVEGA 9MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | S |
INVIRASE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover INVIRASE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
INVIRASE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover INVIRASE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
IONOSOL B-D5W IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover IONOSOL B-D5W IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IONOSOL MB-D5W IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover IONOSOL MB-D5W IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IONOSOL T-D5W IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover IONOSOL T-D5W IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IOPIDINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover IOPIDINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IPOL VIAL 40;8;32; UNT ![Compare how all Medicare Part D PDP plans in IA cover IPOL VIAL 40;8;32; UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
IPRATROPIUM BROMIDE 42MCG AEROSOL SPRAY ![Compare how all Medicare Part D PDP plans in IA cover IPRATROPIUM BROMIDE 42MCG AEROSOL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IPRATROPIUM BROMIDE INHALATION SOLUTION 0.02% 60 X 2.5ML VIALSD ![Compare how all Medicare Part D PDP plans in IA cover IPRATROPIUM BROMIDE INHALATION SOLUTION 0.02% 60 X 2.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | P |
IPRATROPIUM BROMIDE NASAL SPRAY ![Compare how all Medicare Part D PDP plans in IA cover IPRATROPIUM BROMIDE NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
IPRATROPIUM BROMIDE/ALBUTEROL SULFATE INHALATION SOLUTION 0.5MG/3ML 33 CRTN ![Compare how all Medicare Part D PDP plans in IA cover IPRATROPIUM BROMIDE/ALBUTEROL SULFATE INHALATION SOLUTION 0.5MG/3ML 33 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | P |
IQUIX 1.5% DROPS ![Compare how all Medicare Part D PDP plans in IA cover IQUIX 1.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
IRESSA 250MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover IRESSA 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
IRINOTECAN HCL INJECTION 20MG ![Compare how all Medicare Part D PDP plans in IA cover IRINOTECAN HCL INJECTION 20MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
ISENTRESS 400MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISENTRESS 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
ISMO 20MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISMO 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOCHRON 40MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover ISOCHRON 40MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOLYTE H IN 5% DEXTROSE ![Compare how all Medicare Part D PDP plans in IA cover ISOLYTE H IN 5% DEXTROSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOLYTE M IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in IA cover ISOLYTE M IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
ISOLYTE P IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in IA cover ISOLYTE P IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOLYTE S IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in IA cover ISOLYTE S IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOLYTE S SOLUTION FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover ISOLYTE S SOLUTION FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISONARIF 300-150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ISONARIF 300-150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
ISONIAZID 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISONIAZID 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISONIAZID 50MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in IA cover ISONIAZID 50MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISONIAZID INJ 100MG/ML ![Compare how all Medicare Part D PDP plans in IA cover ISONIAZID INJ 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
ISONIAZID TABLETS ![Compare how all Medicare Part D PDP plans in IA cover ISONIAZID TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOPTIN SR 120MG ![Compare how all Medicare Part D PDP plans in IA cover ISOPTIN SR 120MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOPTIN SR 180MG ![Compare how all Medicare Part D PDP plans in IA cover ISOPTIN SR 180MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOPTIN SR 240MG (500 Count) ![Compare how all Medicare Part D PDP plans in IA cover ISOPTIN SR 240MG (500 Count).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISORDIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISORDIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISORDIL TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover ISORDIL TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOSORBIDE DINITRATE TABLETS ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DINITRATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE DINITRATE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DINITRATE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE DN 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE DN 2.5 MG TAB SL ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DN 2.5 MG TAB SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE DN 20MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE DN 30MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DN 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE DN 5MG TABLET SL ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE DN 5MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOSORBIDE MN 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE MN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE MONONITRATE 20 MG ORAL TABLET [MONOKET] ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE MONONITRATE 20 MG ORAL TABLET [MONOKET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
ISOSORBIDE MONONITRATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE MONONITRATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE MONONITRATE ER TABLET 30MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE MONONITRATE ER TABLET 30MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOSORBIDE MONONITRATE TABLETS EXTENDED RELEASE 60MG 100 TABLETS BOT ![Compare how all Medicare Part D PDP plans in IA cover ISOSORBIDE MONONITRATE TABLETS EXTENDED RELEASE 60MG 100 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISOTON GENTAMICIN 60MG/100ML ![Compare how all Medicare Part D PDP plans in IA cover ISOTON GENTAMICIN 60MG/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
ISOTON GENTAMICIN 80MG/100ML ![Compare how all Medicare Part D PDP plans in IA cover ISOTON GENTAMICIN 80MG/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |
ISRADIPINE CAPSULES 2.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ISRADIPINE CAPSULES 2.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISRADIPINE CAPSULES 5MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover ISRADIPINE CAPSULES 5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Brand |
$4.00 | $8.00 | None |
ISTALOL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover ISTALOL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$79.00 | $222.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISTODAX KIT ![Compare how all Medicare Part D PDP plans in IA cover ISTODAX KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | P |
ITRACONAZOLE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover ITRACONAZOLE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | P Q:130 /31Days |
IV BUSULFEX 6MG 1 X 10ML VIALGL ![Compare how all Medicare Part D PDP plans in IA cover IV BUSULFEX 6MG 1 X 10ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
IXEMPRA KIT 45MG ![Compare how all Medicare Part D PDP plans in IA cover IXEMPRA KIT 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Specialty |
33% | 33% | None |
IXIARO JAPANESE ENCEPHALITIS VACCINE 6MCG/.5ML ![Compare how all Medicare Part D PDP plans in IA cover IXIARO JAPANESE ENCEPHALITIS VACCINE 6MCG/.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Generic Preferred Brand |
$40.00 | $105.00 | None |