2011 Medicare Part D Plan Formulary Information |
WellCare Classic (PDP) (S5967-138-0)
Benefit Details
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The WellCare Classic (PDP) (S5967-138-0) Formulary Drugs Starting with the Letter C in CMS PDP Region 01 which includes: ME NH
|
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CALCIPOTRIENE OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover CALCIPOTRIENE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CALCIPOTRIENE TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CALCIPOTRIENE TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in NH cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CALCITRIOL 0.25MCG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CALCITRIOL 0.25MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | P |
CALCITRIOL 0.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CALCITRIOL 0.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | P |
CALCITRIOL 1MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in NH cover CALCITRIOL 1MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CALCITRIOL 2 MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover CALCITRIOL 2 MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CALCITRIOL INJECTION SOLUTION 1MCG 50 X 01ML AMP ![Compare how all Medicare Part D PDP plans in NH cover CALCITRIOL INJECTION SOLUTION 1MCG 50 X 01ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in NH cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CALCIUM CHLORIDE 0.0014 MEQ/ML / POTASSIUM CHLORIDE 0.004 MEQ/ML / SODIUM CHLORIDE 0.103 MEQ/ML / SO ![Compare how all Medicare Part D PDP plans in NH cover CALCIUM CHLORIDE 0.0014 MEQ/ML / POTASSIUM CHLORIDE 0.004 MEQ/ML / SODIUM CHLORIDE 0.103 MEQ/ML / SO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAMILA 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAMILA 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CAMPATH 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover CAMPATH 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
CAMPRAL 333MG DOSE PAK ![Compare how all Medicare Part D PDP plans in NH cover CAMPRAL 333MG DOSE PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX ![Compare how all Medicare Part D PDP plans in NH cover CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CAPREOMYCIN 500 MG/ML INJECTABLE SOLUTION [CAPASTAT] ![Compare how all Medicare Part D PDP plans in NH cover CAPREOMYCIN 500 MG/ML INJECTABLE SOLUTION [CAPASTAT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | None |
CAPTOPRIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CAPTOPRIL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CAPTOPRIL 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CAPTOPRIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CAPTOPRIL/HCTZ 25/15 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL/HCTZ 25/15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CAPTOPRIL/HCTZ 25/25 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL/HCTZ 25/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAPTOPRIL/HCTZ 50/15 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL/HCTZ 50/15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CAPTOPRIL/HCTZ 50/25 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CAPTOPRIL/HCTZ 50/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARAC CRE 0.5% ![Compare how all Medicare Part D PDP plans in NH cover CARAC CRE 0.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CARAFATE SUS 1GM/10ML ![Compare how all Medicare Part D PDP plans in NH cover CARAFATE SUS 1GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CARBAMAZEPINE ORAL SUSPENSION 200 MG ![Compare how all Medicare Part D PDP plans in NH cover CARBAMAZEPINE ORAL SUSPENSION 200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CARBAMAZEPINE TABLET CHEWABLE 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARBAMAZEPINE TABLET CHEWABLE 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARBAMAZEPINE TABLET USP 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARBAMAZEPINE TABLET USP 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARBIDOPA-LEVODOPA 25MG-100MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover CARBIDOPA-LEVODOPA 25MG-100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CARBIDOPA-LEVODOPA 50MG-200MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover CARBIDOPA-LEVODOPA 50MG-200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CARBIDOPA/LEVO 10/100 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CARBIDOPA/LEVO 10/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARBIDOPA/LEVO 25/100 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CARBIDOPA/LEVO 25/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA/LEVO 25/250 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CARBIDOPA/LEVO 25/250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARIMUNE NF 3GM VIAL ![Compare how all Medicare Part D PDP plans in NH cover CARIMUNE NF 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
CARISOPRODOL TABLET USP 350MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARISOPRODOL TABLET USP 350MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | Q:124 /31Days |
CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARTIA XT 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in NH cover CARTIA XT 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARVEDILOL 12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARVEDILOL 12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARVEDILOL 25MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARVEDILOL 25MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARVEDILOL 3.125MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARVEDILOL 3.125MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARVEDILOL 6.25MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CARVEDILOL 6.25MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEENU 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CEENU 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEENU 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CEENU 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEENU 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CEENU 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFACLOR 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in NH cover CEFACLOR 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFACLOR 375MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in NH cover CEFACLOR 375MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFACLOR CAPSULES ![Compare how all Medicare Part D PDP plans in NH cover CEFACLOR CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFACLOR CAPSULES ![Compare how all Medicare Part D PDP plans in NH cover CEFACLOR CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFACLOR POWDER FOR ORAL SUSPENSION USP 125MG 75ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CEFACLOR POWDER FOR ORAL SUSPENSION USP 125MG 75ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFADROXIL 1G TABLET ![Compare how all Medicare Part D PDP plans in NH cover CEFADROXIL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFADROXIL 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CEFADROXIL 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFADROXIL 500MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in NH cover CEFADROXIL 500MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFADROXIL FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CEFADROXIL FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFAZOLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFAZOLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFAZOLIN 1GM/D5W BAG ![Compare how all Medicare Part D PDP plans in NH cover CEFAZOLIN 1GM/D5W BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFAZOLIN 20GM BULK VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFAZOLIN 20GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFAZOLIN FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CEFAZOLIN FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in NH cover CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFDINIR CAPSULES 300MG (60 CT) ![Compare how all Medicare Part D PDP plans in NH cover CEFDINIR CAPSULES 300MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFEPIME INJ 1GM 20ML APX 10x1G VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFEPIME INJ 1GM 20ML APX 10x1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFOTAXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CEFOTAXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFOTAXIME FOR INJECTION 1GM 50 BOX VIALGL ![Compare how all Medicare Part D PDP plans in NH cover CEFOTAXIME FOR INJECTION 1GM 50 BOX VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFOTAXIME FOR INJECTION 2GM 25 VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFOTAXIME FOR INJECTION 2GM 25 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFOTAXIME FOR INJECTION 500MG 10 VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFOTAXIME FOR INJECTION 500MG 10 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFOXITIN 180 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CEFOXITIN 180 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFOXITIN 95 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CEFOXITIN 95 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFOXITIN FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CEFOXITIN FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFPODOXIME PROXETIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CEFPODOXIME PROXETIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT) ![Compare how all Medicare Part D PDP plans in NH cover CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 50MG 50ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CEFPODOXIME PROXETIL FOR ORAL SUSPENSION 50MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFPROZIL 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CEFPROZIL 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFPROZIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in NH cover CEFPROZIL 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFPROZIL FOR ORAL SUSPENSION 125MG/5ML 75ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CEFPROZIL FOR ORAL SUSPENSION 125MG/5ML 75ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFPROZIL TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover CEFPROZIL TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFTAZIDIME FOR INJECTION 1GM/VIAL 1 SINGLE VIAL VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFTAZIDIME FOR INJECTION 1GM/VIAL 1 SINGLE VIAL VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN ![Compare how all Medicare Part D PDP plans in NH cover CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN ![Compare how all Medicare Part D PDP plans in NH cover CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFTRIAXONE 10GM VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEFTRIAXONE 10GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFTRIAXONE FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CEFTRIAXONE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFTRIAXONE FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CEFTRIAXONE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFTRIAXONE FOR INJECTION 250MG BOX OF 10 VIALGL ![Compare how all Medicare Part D PDP plans in NH cover CEFTRIAXONE FOR INJECTION 250MG BOX OF 10 VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFTRIAXONE FOR INJECTION 500MG BOX OF 10 VIALGL ![Compare how all Medicare Part D PDP plans in NH cover CEFTRIAXONE FOR INJECTION 500MG BOX OF 10 VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFUROXIME 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CEFUROXIME 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEFUROXIME AXETIL 125MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in NH cover CEFUROXIME AXETIL 125MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEFUROXIME AXETIL 500MG TABLET (20 CT) ![Compare how all Medicare Part D PDP plans in NH cover CEFUROXIME AXETIL 500MG TABLET (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CELLCEPT 200MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in NH cover CELLCEPT 200MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CELONTIN 300MG KAPSEAL ![Compare how all Medicare Part D PDP plans in NH cover CELONTIN 300MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CENESTIN 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CENESTIN 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CENESTIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CENESTIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CENESTIN 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CENESTIN 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CENESTIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CENESTIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CENESTIN 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CENESTIN 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CEPHALEXIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CEPHALEXIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEPHALEXIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CEPHALEXIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEPHALEXIN 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in NH cover CEPHALEXIN 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEPHALEXIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CEPHALEXIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEPHALEXIN CAPSULES 500MG (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CEPHALEXIN CAPSULES 500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEPHALEXIN POWDER FOR SUSPENSION ORAL USP 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CEPHALEXIN POWDER FOR SUSPENSION ORAL USP 125MG 200ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEREDASE 80UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover CEREDASE 80UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
CEREZYME INJ 200UNIT ![Compare how all Medicare Part D PDP plans in NH cover CEREZYME INJ 200UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
CESIA 7 DAYS X 3 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CESIA 7 DAYS X 3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHANTIX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHANTIX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | Q:340 /365Days |
CHANTIX 1MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHANTIX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | Q:340 /365Days |
CHANTIX STARTING MONTH PAK ![Compare how all Medicare Part D PDP plans in NH cover CHANTIX STARTING MONTH PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | Q:106 /365Days |
CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH ![Compare how all Medicare Part D PDP plans in NH cover CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLOROQUINE PH 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLOROQUINE PH 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT) ![Compare how all Medicare Part D PDP plans in NH cover CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CHLOROTHIAZIDE 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLOROTHIAZIDE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLOROTHIAZIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLOROTHIAZIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLOROTHIAZIDE SODIUM FOR INJECTION 500MG/VIAL ![Compare how all Medicare Part D PDP plans in NH cover CHLOROTHIAZIDE SODIUM FOR INJECTION 500MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CHLORPROMAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROMAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORPROMAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROMAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORPROMAZINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROMAZINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORPROMAZINE 25MG/ML AMP ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROMAZINE 25MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CHLORPROMAZINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROMAZINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORPROMAZINE HCL 200MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROMAZINE HCL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORPROPAMIDE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROPAMIDE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORPROPAMIDE 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover CHLORPROPAMIDE 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORTHALIDONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CHLORTHALIDONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORTHALIDONE 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover CHLORTHALIDONE 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLORZOXAZONE 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CHLORZOXAZONE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in NH cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CICLOPIROX 0.77% CREAM ![Compare how all Medicare Part D PDP plans in NH cover CICLOPIROX 0.77% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CICLOPIROX 0.77% TOPICAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover CICLOPIROX 0.77% TOPICAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CICLOPIROX 1% SHAMPOO ![Compare how all Medicare Part D PDP plans in NH cover CICLOPIROX 1% SHAMPOO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CICLOPIROX 8% TOPICAL SOLUTION NAIL LACQUER 6.6ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CICLOPIROX 8% TOPICAL SOLUTION NAIL LACQUER 6.6ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CICLOPIROX GEL ![Compare how all Medicare Part D PDP plans in NH cover CICLOPIROX GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CILOSTAZOL 50MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in NH cover CILOSTAZOL 50MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CILOSTAZOL TABLET 100MG (60 CT) ![Compare how all Medicare Part D PDP plans in NH cover CILOSTAZOL TABLET 100MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CIMETIDINE 200MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CIMETIDINE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIMETIDINE HCL 300MG/5ML SOL ![Compare how all Medicare Part D PDP plans in NH cover CIMETIDINE HCL 300MG/5ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIMETIDINE TABLETS ![Compare how all Medicare Part D PDP plans in NH cover CIMETIDINE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIMETIDINE TABLETS ![Compare how all Medicare Part D PDP plans in NH cover CIMETIDINE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIMETIDINE TABLETS USP ![Compare how all Medicare Part D PDP plans in NH cover CIMETIDINE TABLETS USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CIPROFLOXACIN 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN 400 MG/40 ML VL ![Compare how all Medicare Part D PDP plans in NH cover CIPROFLOXACIN 400 MG/40 ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CIPROFLOXACIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN HCL 0.3% DROPS ![Compare how all Medicare Part D PDP plans in NH cover CIPROFLOXACIN HCL 0.3% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN TABLETS 750MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover CIPROFLOXACIN TABLETS 750MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CITALOPRAM HBR 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CITALOPRAM HBR 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL ![Compare how all Medicare Part D PDP plans in NH cover CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in NH cover CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CITOLOPRAM HBR 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CITOLOPRAM HBR 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLARITHROMYCIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CLARITHROMYCIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLARITHROMYCIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CLARITHROMYCIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLARITHROMYCIN FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover CLARITHROMYCIN FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLARITHROMYCIN FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover CLARITHROMYCIN FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLINDAMYCIN 150MG/ML ADDVAN ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN 150MG/ML ADDVAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINDAMYCIN HCL 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN HCL 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLINDAMYCIN HYDROCHLORIDE CAPSULES ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN HYDROCHLORIDE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLINDAMYCIN PHOSPHATE 1% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN PHOSPHATE 1% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLINDAMYCIN PHOSPHATE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in NH cover CLINDAMYCIN PHOSPHATE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINIMIX 2.75%/5% INJECTION 1000ML BAG ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 2.75%/5% INJECTION 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 4.25/10 SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 4.25/10 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 4.25/20 SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 4.25/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 4.25/25 SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 4.25/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 4.25/5 SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 4.25/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 5/15 SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 5/15 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 5/20 SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 5/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINIMIX 5/25 SULFITE FREE INJECTIONS 1035MG-420MEQ 1000ML BAG ![Compare how all Medicare Part D PDP plans in NH cover CLINIMIX 5/25 SULFITE FREE INJECTIONS 1035MG-420MEQ 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLINISOL 15% SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLINISOL 15% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOBETASOL 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CLOBETASOL 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOBETASOL E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in NH cover CLOBETASOL E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLODERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in NH cover CLODERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CLOMIPRAMINE HCL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CLOMIPRAMINE HCL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLOMIPRAMINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CLOMIPRAMINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLOMIPRAMINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CLOMIPRAMINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLONIDINE HCL 0.2MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CLONIDINE HCL 0.2MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLONIDINE HCL TABLET 0.1MG (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CLONIDINE HCL TABLET 0.1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLONIDINE HCL TABLET 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CLONIDINE HCL TABLET 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLORPRES 0.1-15 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CLORPRES 0.1-15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLORPRES 0.2-15 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CLORPRES 0.2-15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLORPRES 0.3-15 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CLORPRES 0.3-15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in NH cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION ![Compare how all Medicare Part D PDP plans in NH cover CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE CREAM USP .5MG-10GM 45GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE CREAM USP .5MG-10GM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLOZAPINE 100 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in NH cover CLOZAPINE 100 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOZAPINE 12.5 MG DISINTEGRATING TABLET [FAZACLO] ![Compare how all Medicare Part D PDP plans in NH cover CLOZAPINE 12.5 MG DISINTEGRATING TABLET [FAZACLO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CLOZAPINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CLOZAPINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOZAPINE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CLOZAPINE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CLOZAPINE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CLOZAPINE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CO-GESIC 5/500 TABLET ![Compare how all Medicare Part D PDP plans in NH cover CO-GESIC 5/500 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:248 /31Days |
CODEINE 60 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in NH cover CODEINE 60 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | Q:248 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CODEINE SULFATE 30 MG TABLET 3100 ![Compare how all Medicare Part D PDP plans in NH cover CODEINE SULFATE 30 MG TABLET 3100.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | Q:248 /31Days |
CODEINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in NH cover CODEINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | Q:248 /31Days |
COLCHICINE 0.6 MG ORAL TABLET [COLCRYS] ![Compare how all Medicare Part D PDP plans in NH cover COLCHICINE 0.6 MG ORAL TABLET [COLCRYS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
COLESTIPOL HCL 1G TABLET ![Compare how all Medicare Part D PDP plans in NH cover COLESTIPOL HCL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COLESTIPOL HCL 5G GRANULES ![Compare how all Medicare Part D PDP plans in NH cover COLESTIPOL HCL 5G GRANULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COLISTIMETHATE 150MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover COLISTIMETHATE 150MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
COLOCORT 100MG ENEMA ![Compare how all Medicare Part D PDP plans in NH cover COLOCORT 100MG ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
COMBIPATCH 0.05/0.14MG PTCH ![Compare how all Medicare Part D PDP plans in NH cover COMBIPATCH 0.05/0.14MG PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COMBIPATCH 0.05/0.25MG PTCH ![Compare how all Medicare Part D PDP plans in NH cover COMBIPATCH 0.05/0.25MG PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COMBIVENT INHALER ![Compare how all Medicare Part D PDP plans in NH cover COMBIVENT INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COMBIVIR TABLETS ![Compare how all Medicare Part D PDP plans in NH cover COMBIVIR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COMPRO 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in NH cover COMPRO 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COMTAN 200MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COMTAN 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COMVAX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in NH cover COMVAX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CONDYLOX GEL 0.5% 3.5 GM CRTN ![Compare how all Medicare Part D PDP plans in NH cover CONDYLOX GEL 0.5% 3.5 GM CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in NH cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
CORDRAN 0.05% LOTION ![Compare how all Medicare Part D PDP plans in NH cover CORDRAN 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
COREG CR 10MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in NH cover COREG CR 10MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COREG CR 20MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in NH cover COREG CR 20MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COREG CR 40MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in NH cover COREG CR 40MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COREG CR 80MG CAPSULE MULTIPHASIC RELEASE 24 HR ![Compare how all Medicare Part D PDP plans in NH cover COREG CR 80MG CAPSULE MULTIPHASIC RELEASE 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CORTIFOAM RECTAL FOAM ![Compare how all Medicare Part D PDP plans in NH cover CORTIFOAM RECTAL FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CORTISONE ACETATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CORTISONE ACETATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CORTOMYCIN EAR SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CORTOMYCIN EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CORTOMYCIN EAR SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover CORTOMYCIN EAR SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
COUMADIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 1MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 3MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 4MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COUMADIN 5MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 6MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
COUMADIN 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover COUMADIN 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | None |
CRIXIVAN 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CRIXIVAN 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CRIXIVAN 333MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CRIXIVAN 333MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CRIXIVAN 400MG CAPSULE (120 CT) ![Compare how all Medicare Part D PDP plans in NH cover CRIXIVAN 400MG CAPSULE (120 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CROMOLYN NEBULIZER SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover CROMOLYN NEBULIZER SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CUPRIMINE CAPSULES 250MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover CUPRIMINE CAPSULES 250MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | Q:93 /31Days |
CYCLOBENZAPRINE HCL 5MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover CYCLOBENZAPRINE HCL 5MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | Q:93 /31Days |
CYCLOPHOSPHAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CYCLOPHOSPHAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYCLOPHOSPHAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover CYCLOPHOSPHAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYCLOSPORINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYCLOSPORINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYCLOSPORINE 50MG/ML AMP ![Compare how all Medicare Part D PDP plans in NH cover CYCLOSPORINE 50MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in NH cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYKLOKAPRON 100MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in NH cover CYKLOKAPRON 100MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | None |
CYMBALTA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYMBALTA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | S |
CYMBALTA 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYMBALTA 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | S |
CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in NH cover CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | S |
CYPROHEPTADINE HCL 4 MG ![Compare how all Medicare Part D PDP plans in NH cover CYPROHEPTADINE HCL 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL ![Compare how all Medicare Part D PDP plans in NH cover CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CYSTADANE POWDER FOR ORAL SOLUTION 180GM ![Compare how all Medicare Part D PDP plans in NH cover CYSTADANE POWDER FOR ORAL SOLUTION 180GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic and Preferred Brand |
$43.00 | $107.00 | P |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |
CYTOVENE IV INJECTION ![Compare how all Medicare Part D PDP plans in NH cover CYTOVENE IV INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Generic and Non-Preferred Brand |
$94.00 | $235.00 | P |