Q1GROUP LLC | Q1Medicare.com - a non-government resource for the Medicare community
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

Select your search style and criteria below or use this example to get started

Search by:
State & Plan   ZIP & Plan   PlanID   FormularyID

Search Criteria
PDP     MAPD
Scroll down to see formulary results.

WellCare Signature (PDP) (S5967-042-0)
Tier 1 (1636)
Tier 2 (356)
Tier 3 (285)
Tier 4 (186)

Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either
Cick on the first letter of your drug name to browse the formulary:

A B C D E F G H I J K L 
M N O P Q R S T U V W X Y Z 0-9 
2011 Medicare Part D Plan Formulary Information
WellCare Signature (PDP) (S5967-042-0)
Benefit Details           
The WellCare Signature (PDP) (S5967-042-0)
Formulary Drugs Starting with the Letter D

in CMS PDP Region 8 which includes: NC
Drugs Starting with Letter D

Drug Name
Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
D5W/KCL 20MEQ/L IV SOLUTION   2 Preferred Brand $38.00$95.00None
DANAZOL 100MG CAPSULE   1 Generic $0.00$0.00None
DANAZOL 50MG CAPSULE   1 Generic $0.00$0.00None
DANAZOL CAPSULES USP 200MG (100 CT)   1 Generic $0.00$0.00None
DAPSONE TABLETS 100MG 30 BLPK   2 Preferred Brand $38.00$95.00None
DAPSONE TABLETS 25MG 30 BLPK   2 Preferred Brand $38.00$95.00None
DAPTACEL VACCINE 15;5;5;3; LF/.5ML   2 Preferred Brand $38.00$95.00None
DARAPRIM 25MG TABLET   2 Preferred Brand $38.00$95.00None
DECAVAC VACCINE 2;5 UNT/0.5 ML   2 Preferred Brand $38.00$95.00None
DEMECLOCYCLINE HCL 150MG TABLET   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEMECLOCYCLINE HCL 300MG TABLET   1 Generic $0.00$0.00None
DENAVIR 1% CREAM   2 Preferred Brand $38.00$95.00None
DEPADE 50MG TABLET   1 Generic $0.00$0.00None
DERMA-SMOOTHE/FS 0.01% BODY OIL   2 Preferred Brand $38.00$95.00None
DERMOTIC 0.01% DROPS   2 Preferred Brand $38.00$95.00None
DESIPRAMINE 25MG TABLET   1 Generic $0.00$0.00None
DESIPRAMINE 50MG TABLET   1 Generic $0.00$0.00None
DESIPRAMINE HCL 75MG TABLET (100 CT)   1 Generic $0.00$0.00None
DESIPRAMINE HYDROCHLORIDE TABLETS   1 Generic $0.00$0.00None
DESIPRAMINE HYDROCHLORIDE TABLETS 10MG 100 BOT   1 Generic $0.00$0.00None
DESIPRAMINE HYDROCHLORIDE TABLETS USP 100MG 100 BOT   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DESMOPRESSIN 0.1MG/ML SOL   1 Generic $0.00$0.00Q:15
/31Days
DESMOPRESSIN AC 4MCG/ML VL   1 Generic $0.00$0.00None
DESMOPRESSIN ACETATE 0.1MG TABLET   1 Generic $0.00$0.00None
DESMOPRESSIN ACETATE NASAL SOLUTION 0.1% 5 ML BOTSPR   1 Generic $0.00$0.00Q:15
/31Days
DESMOPRESSIN ACETATE TABLET 0.2MG (100 CT)   1 Generic $0.00$0.00None
DESONIDE 0.05% CREAM   1 Generic $0.00$0.00None
DESONIDE 0.05% LOTION   1 Generic $0.00$0.00None
DESONIDE 0.05% OINTMENT 60GM TUBE   1 Generic $0.00$0.00None
DESOXIMETASONE 0.05% CREAM   1 Generic $0.00$0.00None
DESOXIMETASONE 0.05% GEL   1 Generic $0.00$0.00None
DESOXIMETASONE 0.25% CREAM   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DESOXIMETASONE 0.25% OINT   1 Generic $0.00$0.00None
DEXAMETHASONE 0.5MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE 0.5MG/5ML ELX   1 Generic $0.00$0.00None
DEXAMETHASONE 0.75MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE 1.5MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE 1MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE 2MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE 4MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE 6MG TABLET   1 Generic $0.00$0.00None
DEXAMETHASONE SODIUM PHOSPHATE 0.1% DROPS   1 Generic $0.00$0.00None
DEXAMETHASONE SODIUM PHOSPHATE INJECTION 4MG 30ML VIALMD   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEXMETHYLPHENIDATE HCL 10MG TABLET   1 Generic $0.00$0.00None
DEXMETHYLPHENIDATE HCL 2.5MG TABLET   1 Generic $0.00$0.00None
DEXMETHYLPHENIDATE HCL 5MG TABLET   1 Generic $0.00$0.00None
DEXTROAMPHETAMINE 10MG TABLET   1 Generic $0.00$0.00P
DEXTROAMPHETAMINE 5MG TABLET   1 Generic $0.00$0.00P
DEXTROAMPHETAMINE SACCHARATE AND SULFATE AMPHETAMINE ASPARTATE 10MG TABLET (100 CT)   1 Generic $0.00$0.00P
DEXTROSE 10%-1/4NS IV TUBEX   2 Preferred Brand $38.00$95.00None
DEXTROSE 2.5%-1/2NS IV SOLUTION   2 Preferred Brand $38.00$95.00None
DEXTROSE 5% AND 0.9% NACL INJECTION 5-900 24 X 500ML BAG   2 Preferred Brand $38.00$95.00None
DEXTROSE 5%-1/4NS IV SOLUTION   2 Preferred Brand $38.00$95.00None
DEXTROSE AND ELECTROLYTE NO 48 INJECTION 5% 500ML BAG   2 Preferred Brand $38.00$95.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEXTROSE IN SODIUM CHLORIDE INJECTION   2 Preferred Brand $38.00$95.00None
DEXTROSE IN SODIUM CHLORIDE INJECTION   2 Preferred Brand $38.00$95.00None
DEXTROSE IN SODIUM CHLORIDE INJECTION 1000ML X 12 CASE   2 Preferred Brand $38.00$95.00None
DEXTROSE IN SODIUM CHLORIDE INJECTION 500ML X 24 BAG   2 Preferred Brand $38.00$95.00None
DEXTROSE INJECTION 10 250ML X 24 BOTPL   2 Preferred Brand $38.00$95.00None
DEXTROSE INJECTION USP 5 4 X 100ML CTR   2 Preferred Brand $38.00$95.00None
DICLOFENAC POTASSIUM 50MG TABLET (500 CT)   1 Generic $0.00$0.00None
DICLOFENAC SOD 100MG TABLET SA   1 Generic $0.00$0.00None
DICLOFENAC SODIUM 0.1% DROPS   1 Generic $0.00$0.00None
DICLOFENAC SODIUM 50MG TABLET DELAYED RELEASE (100 CT)   1 Generic $0.00$0.00None
DICLOFENAC SODIUM 75MG TABLET DELAYED RELEASE   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DICLOXACILLIN 250MG CAPSULE   1 Generic $0.00$0.00None
DICLOXACILLIN SODIUM 500MG CAP   1 Generic $0.00$0.00None
DICYCLOMINE 10MG CAPSULE   1 Generic $0.00$0.00None
DICYCLOMINE 10MG/ML VIAL   1 Generic $0.00$0.00None
DICYCLOMINE HCL 10MG/5ML SYRUP   1 Generic $0.00$0.00None
DICYCLOMINE HCL 20MG TABLET (500 CT)   1 Generic $0.00$0.00None
DIDANOSINE 200MG CAPSULE DELAYED RELEASE   1 Generic $0.00$0.00None
DIDANOSINE 250MG CAPSULE DELAYED RELEASE   1 Generic $0.00$0.00None
DIDANOSINE 400MG CAPSULE DELAYED RELEASE   1 Generic $0.00$0.00None
DIDANOSINE DELAYED RELEASE CAPSULES 125MG 30 BOT   1 Generic $0.00$0.00None
DIFLORASONE 0.05% CREAM   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DIFLORASONE 0.05% OINTMENT   1 Generic $0.00$0.00None
DIFLUNISAL 500MG TABLET   1 Generic $0.00$0.00None
DIGOXIN 125MCG TABLET   1 Generic $0.00$0.00None
DIGOXIN 250MCG TABLET (1000 CT)   1 Generic $0.00$0.00None
DIGOXIN 50MCG/ML SOLUTION ORAL   1 Generic $0.00$0.00None
DIGOXIN INJECTION 500MCG 25 X 2ML AMP   1 Generic $0.00$0.00None
DIHYDROERGOTAMINE 1MG/ML AM   1 Generic $0.00$0.00None
DILANTIN 50MG INFATAB   2 Preferred Brand $38.00$95.00None
DILANTIN CAPSULES EXTENDED RELEASE   2 Preferred Brand $38.00$95.00None
DILT-CD 120MG CAPSULE SR 24 HR   1 Generic $0.00$0.00None
DILT-CD DILTIAZEM HCL ER CAPSULES 300MG   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DILT-XR 180MG CAPSULE DEGRADABLE CONTROLLED-RELEASE   1 Generic $0.00$0.00None
DILTIAZEM 24HR ER 180 MG TAB   1 Generic $0.00$0.00None
DILTIAZEM 24HR ER 240 MG TAB   1 Generic $0.00$0.00None
DILTIAZEM 24HR ER 300 MG TAB   1 Generic $0.00$0.00None
DILTIAZEM 24HR ER 360 MG TAB   1 Generic $0.00$0.00None
DILTIAZEM 24HR ER 420 MG TAB   1 Generic $0.00$0.00None
DILTIAZEM 30MG TABLET   1 Generic $0.00$0.00None
DILTIAZEM 90MG TABLET   1 Generic $0.00$0.00None
DILTIAZEM CD CAPSULES 120MG (90 CT)   1 Generic $0.00$0.00None
DILTIAZEM CD CAPSULES 240MG (90 CT)   1 Generic $0.00$0.00None
DILTIAZEM CD CAPSULES 300MG (90 CT)   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DILTIAZEM ER 240MG CAPSULE SA   1 Generic $0.00$0.00None
DILTIAZEM ER 420MG CAPSULE SA   1 Generic $0.00$0.00None
DILTIAZEM HCL 100MG VIAL   1 Generic $0.00$0.00None
DILTIAZEM HCL 120MG ER CAPSULE   1 Generic $0.00$0.00None
DILTIAZEM HCL 120MG TABLET   1 Generic $0.00$0.00None
DILTIAZEM HCL 60MG ER CAPSULE   1 Generic $0.00$0.00None
DILTIAZEM HCL 60MG TABLET   1 Generic $0.00$0.00None
DILTIAZEM HYDROCHLORIDE CAPSULES EXTENDED RELEASE   1 Generic $0.00$0.00None
DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES USP 90MG 1 BLPK   1 Generic $0.00$0.00None
DILTIAZEM HYDROCHLORIDE INJECTION   1 Generic $0.00$0.00None
DILTZAC DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES 120MG   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DILTZAC DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES 180MG   1 Generic $0.00$0.00None
DILTZAC DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES 240MG   1 Generic $0.00$0.00None
DILTZAC DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES 300MG   1 Generic $0.00$0.00None
DILTZAC ER CAPSULE   1 Generic $0.00$0.00None
DIOVAN 160MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN 320MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN 40MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN 80MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN HCT 160/12.5MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN HCT 160/25MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN HCT 320/12.5MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DIOVAN HCT 320/25MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIOVAN HCT 80/12.5MG TABLET   3 Non-Preferred Brand $70.00$175.00Q:31
/31Days
DIPHENHYDRAMINE 50MG CAPS   1 Generic $0.00$0.00None
DIPHENHYDRAMINE HCL ELIXIR 12.5MG/5ML 20 ML PKG   1 Generic $0.00$0.00None
DIPHENHYDRAMINE HCL INJECTION 50MG 1 VIAL   1 Generic $0.00$0.00None
DIPHENOXYLATE/ATROPINE LIQ   1 Generic $0.00$0.00None
DIPHTHERIA-TETANUS TOX-PED .17;6.7;5 MG/5ML;LF   2 Preferred Brand $38.00$95.00None
DIPYRIDAMOLE TABETS 25MG 100 BOT   1 Generic $0.00$0.00None
DIPYRIDAMOLE TABLETS 50MG 100 BOT   1 Generic $0.00$0.00None
DIPYRIDAMOLE TABLETS 75MG 100 BOT   1 Generic $0.00$0.00None
DISOPYRAMIDE PHOSPHATE 150MG CAPSULE USP (100 CT)   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DISOPYRAMIDE PHOSPHATE CAPSULES 100MG (100 CT)   1 Generic $0.00$0.00None
DIVALPROEX SODIUM 125MG TBEC   1 Generic $0.00$0.00None
DIVALPROEX SODIUM 250MG TBEC   1 Generic $0.00$0.00None
DIVALPROEX SODIUM 500MG TBEC   1 Generic $0.00$0.00None
DIVALPROEX SODIUM COATED PARTICLES IN CAPSULES 125MG 100 BOT   1 Generic $0.00$0.00None
DIVALPROEX SODIUM EXTENDED RELEASE TABLETS 250MG 100 BOT   1 Generic $0.00$0.00None
DIVALPROEX SODIUM TABLETS EXTENDED RELEASE 500MG 100 BOT   1 Generic $0.00$0.00None
DONEPEZIL HYDROCHLORIDE TABLETS   1 Generic $0.00$0.00None
DONEPEZIL HYDROCHLORIDE TABLETS   1 Generic $0.00$0.00None
DONEPEZIL HYDROCHLORIDE TABLETS   1 Generic $0.00$0.00None
DONEPEZIL HYDROCHLORIDE TABLETS   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DORZOLAMIDE HCL OPHTHALMIC 2% 10 ML BOTDR   1 Generic $0.00$0.00None
DORZOLAMIDE HCL TIMOLOL MALEATE OPHTHALMIC SOLUTION 22.3;6.8MG/ML;   1 Generic $0.00$0.00None
DOVONEX CREAM   3 Non-Preferred Brand $70.00$175.00None
DOXAZOSIN MESYLATE 4MG TABLET   1 Generic $0.00$0.00None
DOXAZOSIN MESYLATE TABLET 2MG (500 CT)   1 Generic $0.00$0.00None
DOXAZOSIN MESYLATE TABLET 8MG (500 CT)   1 Generic $0.00$0.00None
DOXAZOSIN TABLET 1MG (100 CT)   1 Generic $0.00$0.00None
DOXEPIN 10MG CAPSULE   1 Generic $0.00$0.00None
DOXEPIN 10MG/ML ORAL CONC   1 Generic $0.00$0.00None
DOXEPIN 50 MG ORAL CAPSULE   1 Generic $0.00$0.00None
DOXEPIN 75MG CAPSULE   1 Generic $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DOXEPIN HCL 25MG CAPSULE (100 CT)   1 Generic $0.00$0.00None
DOXEPIN HYDROCHLORIDE CAPSULES 100MG 100 BOT   1 Generic $0.00$0.00None
DOXERCALCIFEROL 0.001 MG ORAL CAPSULE [HECTOROL]   2 Preferred Brand $38.00$95.00P
DOXYCYCLINE 100MG CAPSULE   1 Generic $0.00$0.00None
DOXYCYCLINE 100MG VIAL   1 Generic $0.00$0.00None
DOXYCYCLINE 50MG CAPSULE   1 Generic $0.00$0.00None
DOXYCYCLINE HYCLATE 100MG TABLET USP (500 CT)   1 Generic $0.00$0.00None
DOXYCYCLINE HYCLATE 20MG TABLET (100 CT)   1 Generic $0.00$0.00None
DRONABINOL CAPS 10MG   1 Generic $0.00$0.00P
DRONABINOL CAPS 2.5MG   1 Generic $0.00$0.00P Q:62
/31Days
DRONABINOL CAPS 5MG   1 Generic $0.00$0.00P
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DROXIA 200MG CAPSULE   2 Preferred Brand $38.00$95.00None
DROXIA 300MG CAPSULE   2 Preferred Brand $38.00$95.00None
DROXIA 400MG CAPSULE   2 Preferred Brand $38.00$95.00None
DULERA INHALATION AEROSOL   2 Preferred Brand $38.00$95.00None
DULERA INHALATION AEROSOL   2 Preferred Brand $38.00$95.00None
DURAMORPH 0.5MG/ML AMPUL   1 Generic $0.00$0.00None
DURAMORPH 1MG/ML AMPUL   1 Generic $0.00$0.00None

Chart Legend:

Below are a few notes to help you understand the above 2011 Medicare Part D WellCare Signature (PDP) Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region).

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the standard $310 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.

    • No - This plan does not qualify for the $0 Premium for persons with the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.
  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have four (4) tiers 1=Preferred Generics, 2=Preferred Brands, 3=Non-preferred Brands and Generics, 4=Specialty Drugs.
    • Drug Description - This is the Medicare Part D plan’s description of this particular drug tier.
  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $(2840)) at a "Preferred" network pharmacy. In most cases, the "Preferred" network and network pharmacy pricing are the same. However, on the 2011 Humana Walmart-Preferred Rx Plan the pricing is much higher at a network pharmacy over a "Preferred" network pharmacy. "Preferred" network pharmacies for this plan include only Walmart, Sam’s Club and RightSource.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).
  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.




(Chart Source: Centers for Medicare and Medicaid files: CMS Data October 2011 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.