2011 Medicare Part D Plan Formulary Information |
CVS Caremark Plus (PDP) (S5601-051-0)
Benefit Details
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The CVS Caremark Plus (PDP) (S5601-051-0) Formulary Drugs Starting with the Letter F in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FABRAZYME 35MG VIAL ![Compare how all Medicare Part D PDP plans in MT cover FABRAZYME 35MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FAMCICLOVIR 125MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FAMCICLOVIR 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FAMCICLOVIR 250MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FAMCICLOVIR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FAMCICLOVIR 500MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FAMCICLOVIR 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FAMOTIDINE 20MG PIGGYBACK ![Compare how all Medicare Part D PDP plans in MT cover FAMOTIDINE 20MG PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FAMOTIDINE 20MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MT cover FAMOTIDINE 20MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FAMOTIDINE 40MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FAMOTIDINE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FAMOTIDINE FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in MT cover FAMOTIDINE FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD ![Compare how all Medicare Part D PDP plans in MT cover FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FARESTON 60MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FARESTON 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FASLODEX INJECTION ![Compare how all Medicare Part D PDP plans in MT cover FASLODEX INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FAZACLO TABLETS ORALLY DISINTEGRATING ![Compare how all Medicare Part D PDP plans in MT cover FAZACLO TABLETS ORALLY DISINTEGRATING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | P |
FELBATOL 400MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FELBATOL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FELBATOL 600MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FELBATOL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FELBATOL 600MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in MT cover FELBATOL 600MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FELODIPINE ER 2.5MG TABLET 90 TABLET BOT ![Compare how all Medicare Part D PDP plans in MT cover FELODIPINE ER 2.5MG TABLET 90 TABLET BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FELODIPINE TABLET ER 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MT cover FELODIPINE TABLET ER 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FELODIPINE TABLET ER 5MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MT cover FELODIPINE TABLET ER 5MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FEMARA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FEMARA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | None |
FEMHRT 0.5MG/2.5MCG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FEMHRT 0.5MG/2.5MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FEMHRT 1/5 TABLET ![Compare how all Medicare Part D PDP plans in MT cover FEMHRT 1/5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FEMRING 0.05MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in MT cover FEMRING 0.05MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FEMRING 0.10MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in MT cover FEMRING 0.10MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FENOFIBRATE 134MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover FENOFIBRATE 134MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FENOFIBRATE 160MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FENOFIBRATE 160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FENOFIBRATE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover FENOFIBRATE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FENOFIBRATE 54MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FENOFIBRATE 54MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FENOFIBRATE 67MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover FENOFIBRATE 67MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in MT cover FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P Q:10 /30Days |
FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in MT cover FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P Q:10 /30Days |
FENTANYL CITRATE INJECTION 50MCG 10 X 2ML CTG ![Compare how all Medicare Part D PDP plans in MT cover FENTANYL CITRATE INJECTION 50MCG 10 X 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in MT cover FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P Q:10 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in MT cover FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P Q:10 /30Days |
FENTANYL TRANSDERMAL SYSTEM 75MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in MT cover FENTANYL TRANSDERMAL SYSTEM 75MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P Q:10 /30Days |
FEXOFENADINE HCL 180MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FEXOFENADINE HCL 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FEXOFENADINE HCL 30MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FEXOFENADINE HCL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FEXOFENADINE HCL 60MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FEXOFENADINE HCL 60MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FINACEA 15% GEL ![Compare how all Medicare Part D PDP plans in MT cover FINACEA 15% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FINASTERIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FINASTERIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLECAINIDE ACETATE 100 MG TAB #60 EA ![Compare how all Medicare Part D PDP plans in MT cover FLECAINIDE ACETATE 100 MG TAB #60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLECAINIDE ACETATE 150 MG TAB 360 EA ![Compare how all Medicare Part D PDP plans in MT cover FLECAINIDE ACETATE 150 MG TAB 360 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLECAINIDE ACETATE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLECAINIDE ACETATE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLOVENT DISKUS /BLIST AEPB ![Compare how all Medicare Part D PDP plans in MT cover FLOVENT DISKUS /BLIST AEPB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT DISKUS /BLIST AEPB ![Compare how all Medicare Part D PDP plans in MT cover FLOVENT DISKUS /BLIST AEPB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:120 /30Days |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in MT cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:120 /30Days |
FLOVENT HFA 110MCG INHALATION AEROSOL ![Compare how all Medicare Part D PDP plans in MT cover FLOVENT HFA 110MCG INHALATION AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:24 /30Days |
FLOVENT HFA 220MCG INHALATION AEROSOL ![Compare how all Medicare Part D PDP plans in MT cover FLOVENT HFA 220MCG INHALATION AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:24 /30Days |
FLOVENT HFA 44MCG INHALATION AEROSOL ![Compare how all Medicare Part D PDP plans in MT cover FLOVENT HFA 44MCG INHALATION AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:24 /30Days |
FLUCONAZOLE 200MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE 200MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUCONAZOLE 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FLUCONAZOLE ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUCONAZOLE ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUCONAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUCONAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in MT cover FLUCONAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FLUDARABINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in MT cover FLUDARABINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in MT cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:50 /30Days |
FLUOCINOLONE 0.01% CREAM ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINOLONE 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOCINOLONE 0.01% SOLUTION ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINOLONE 0.01% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOCINOLONE 0.025% CREAM ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINOLONE 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOCINOLONE 0.025% OINTMENT ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINOLONE 0.025% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOCINONIDE 0.05% GEL ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINONIDE 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOCINONIDE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINONIDE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINONIDE EMOLLIENT 0.05% CREAM ![Compare how all Medicare Part D PDP plans in MT cover FLUOCINONIDE EMOLLIENT 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOROMETHOLONE 0.1% DROPS ![Compare how all Medicare Part D PDP plans in MT cover FLUOROMETHOLONE 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FLUOROPLEX 1% CREAM ![Compare how all Medicare Part D PDP plans in MT cover FLUOROPLEX 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FLUOROURACIL 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in MT cover FLUOROURACIL 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOROURACIL 5% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in MT cover FLUOROURACIL 5% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOROURACIL CREA 5% ![Compare how all Medicare Part D PDP plans in MT cover FLUOROURACIL CREA 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOROURACIL INJECTION 50MG/ML 10 X 10 ML VIALGL ![Compare how all Medicare Part D PDP plans in MT cover FLUOROURACIL INJECTION 50MG/ML 10 X 10 ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FLUOXETINE 20 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover FLUOXETINE 20 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:30 /30Days |
FLUOXETINE 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MT cover FLUOXETINE 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOXETINE 40MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLUOXETINE 40MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOXETINE CAPSULES 10MG (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLUOXETINE CAPSULES 10MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOXETINE HCL 20MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUOXETINE HCL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT ![Compare how all Medicare Part D PDP plans in MT cover FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:45 /30Days |
FLUPHENAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE DECANOATE INJECTION USP 25MG 1 X 5ML VIAL ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE DECANOATE INJECTION USP 25MG 1 X 5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR ![Compare how all Medicare Part D PDP plans in MT cover FLUPHENAZINE HCL 2.5MG/5ML ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLURBIPROFEN 0.03% EYE DROP ![Compare how all Medicare Part D PDP plans in MT cover FLURBIPROFEN 0.03% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLURBIPROFEN 100MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLURBIPROFEN 100MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FLURBIPROFEN 50MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLURBIPROFEN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FLUTAMIDE 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover FLUTAMIDE 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUTICASONE PROPIONATE 0.005% OINTMENT ![Compare how all Medicare Part D PDP plans in MT cover FLUTICASONE PROPIONATE 0.005% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUTICASONE PROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in MT cover FLUTICASONE PROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in MT cover FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:16 /30Days |
FLUVOXAMINE MALEATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUVOXAMINE MALEATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FLUVOXAMINE MALEATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FLUVOXAMINE MALEATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:45 /30Days |
FLUVOXAMINE MALEATE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FLUVOXAMINE MALEATE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | Q:45 /30Days |
FML S.O.P. 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in MT cover FML S.O.P. 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | None |
FORADIL AEROLIZER 12 MCG CAP ![Compare how all Medicare Part D PDP plans in MT cover FORADIL AEROLIZER 12 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FORTEO INJECTION ![Compare how all Medicare Part D PDP plans in MT cover FORTEO INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in MT cover FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FOSINOPRIL SODIUM 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MT cover FOSINOPRIL SODIUM 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FOSINOPRIL SODIUM 20MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FOSINOPRIL SODIUM 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FOSINOPRIL SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FOSINOPRIL SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FOSINOPRIL-HYDROCHLOROTHIAZIDE 10-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover FOSINOPRIL-HYDROCHLOROTHIAZIDE 20-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | None |
FOSRENOL 1000MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MT cover FOSRENOL 1000MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | None |
FOSRENOL 500MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MT cover FOSRENOL 500MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | None |
FOSRENOL 750MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MT cover FOSRENOL 750MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | None |
FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1 ![Compare how all Medicare Part D PDP plans in MT cover FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /180Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FRAGMIN 2500UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in MT cover FRAGMIN 2500UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:30 /180Days |
FRAGMIN 5000UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in MT cover FRAGMIN 5000UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | Q:30 /180Days |
FRAGMIN INJECTION 10000UNITS 1 X 10 SYR ![Compare how all Medicare Part D PDP plans in MT cover FRAGMIN INJECTION 10000UNITS 1 X 10 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /180Days |
FRAGMIN INJECTION 7500UNT/ML ![Compare how all Medicare Part D PDP plans in MT cover FRAGMIN INJECTION 7500UNT/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /180Days |
FREAMINE HBC INJECTION ![Compare how all Medicare Part D PDP plans in MT cover FREAMINE HBC INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | P |
FREAMINE III INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in MT cover FREAMINE III INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FREAMINE III INJECTION WITH ELECTROLYTES 3% ![Compare how all Medicare Part D PDP plans in MT cover FREAMINE III INJECTION WITH ELECTROLYTES 3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Tier |
$35.00 | $79.00 | P |
FROVA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FROVA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | Q:18 /30Days |
FURADANTIN 25 MG/5 ML SUSP 230 ML ![Compare how all Medicare Part D PDP plans in MT cover FURADANTIN 25 MG/5 ML SUSP 230 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Generic and Non-Preferred Brand Tier |
$90.00 | $248.00 | None |
FUROSEMIDE 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MT cover FUROSEMIDE 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FUROSEMIDE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MT cover FUROSEMIDE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FUROSEMIDE 40MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover FUROSEMIDE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FUROSEMIDE 80MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MT cover FUROSEMIDE 80MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Tier |
$2.00 | $3.00 | None |
FUROSEMIDE INJECTION USP 10MG 25 X 4ML VIALSD ![Compare how all Medicare Part D PDP plans in MT cover FUROSEMIDE INJECTION USP 10MG 25 X 4ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Tier |
$5.00 | $8.00 | P |
FUZEON CONVENIENCE KIT ![Compare how all Medicare Part D PDP plans in MT cover FUZEON CONVENIENCE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |