2012 Medicare Part D Plan Formulary Information |
Medica Prime Solution Enhanced w/Part D Option 2 (Cost) (H2450-002-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Medica Prime Solution Enhanced w/Part D Option 2 (Cost). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Medica Prime Solution Enhanced w/Part D Option 2 (Cost) (H2450-002-0) Formulary Drugs Starting with the Letter B in LAMOURE County, ND: CMS MA Region 19 which includes: ND
|
Drugs Starting with Letter B
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
BACiiM 500001/1 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in ND cover BACiiM 500001/1 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BACITRACIN 500[iU]/g 1 TUBE in 1 CARTON / 3.5 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover BACITRACIN 500[iU]/g 1 TUBE in 1 CARTON / 3.5 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BACITRACIN INJ 50000UNT ![Compare how all Medicare Part D PDP plans in ND cover BACITRACIN INJ 50000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT ![Compare how all Medicare Part D PDP plans in ND cover BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BACLOFEN 10MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BACLOFEN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Baclofen 20mg/1 500 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ND cover Baclofen 20mg/1 500 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BACTRIM 400-80MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BACTRIM 400-80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BACTRIM DS TABLET 800-160 ![Compare how all Medicare Part D PDP plans in ND cover BACTRIM DS TABLET 800-160.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BACTROBAN 2% CREAM ![Compare how all Medicare Part D PDP plans in ND cover BACTROBAN 2% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BACTROBAN 20mg/g 22 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover BACTROBAN 20mg/g 22 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BACTROBAN NASAL 2% OINTMENT ![Compare how all Medicare Part D PDP plans in ND cover BACTROBAN NASAL 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT) ![Compare how all Medicare Part D PDP plans in ND cover BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Balziva 6 POUCH in 1 CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in ND cover Balziva 6 POUCH in 1 CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Banzel 200mg/1 ![Compare how all Medicare Part D PDP plans in ND cover Banzel 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
Banzel 40mg/mL ![Compare how all Medicare Part D PDP plans in ND cover Banzel 40mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BANZEL TABLET 400MG ![Compare how all Medicare Part D PDP plans in ND cover BANZEL TABLET 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BARACLUDE 0.05mg/mL 1 BOTTLE in 1 CARTON / 210 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover BARACLUDE 0.05mg/mL 1 BOTTLE in 1 CARTON / 210 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BARACLUDE 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BARACLUDE 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
BARACLUDE 1MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BARACLUDE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
BECONASE AQ 0.042% SPRAY ![Compare how all Medicare Part D PDP plans in ND cover BECONASE AQ 0.042% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | Q:50 /28Days |
BENAZEPRIL HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENAZEPRIL HCL 20mg/1 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL 20mg/1 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENAZEPRIL HCL 40MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENAZEPRIL HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENICAR 20MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENICAR 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S |
BENICAR 40MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENICAR 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S |
BENICAR 5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENICAR 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S |
BENICAR HCT 20-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENICAR HCT 20-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENICAR HCT 40-25MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENICAR HCT 40-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S |
BENICAR HCT TABLET 12.5-40MG (30 CT) ![Compare how all Medicare Part D PDP plans in ND cover BENICAR HCT TABLET 12.5-40MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S |
BENLYSTA 120mg/1.5mL 1 VIAL in 1 CARTON / 1.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in ND cover BENLYSTA 120mg/1.5mL 1 VIAL in 1 CARTON / 1.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:2 /28Days |
BENTYL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in ND cover BENTYL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BENTYL 10MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in ND cover BENTYL 10MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BENTYL 20MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BENTYL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BENTYL INJECTION 20MG/2ML AMP ![Compare how all Medicare Part D PDP plans in ND cover BENTYL INJECTION 20MG/2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BENZACLIN 50; 10mg/g; mg/g ![Compare how all Medicare Part D PDP plans in ND cover BENZACLIN 50; 10mg/g; mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BENZAMYCIN GEL 50MG/30MG ![Compare how all Medicare Part D PDP plans in ND cover BENZAMYCIN GEL 50MG/30MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
Benztropine Mesylate 1mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Benztropine Mesylate 1mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Benztropine Mesylate 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Benztropine Mesylate 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENZTROPINE MESYLATE INJECTION 2MG/2ML ![Compare how all Medicare Part D PDP plans in ND cover BENZTROPINE MESYLATE INJECTION 2MG/2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENZTROPINE MESYLATE TABLETS ![Compare how all Medicare Part D PDP plans in ND cover BENZTROPINE MESYLATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BENZYL ALCOHOL 50 ML/ML TOPICAL LOTION [ULESFIA] ![Compare how all Medicare Part D PDP plans in ND cover BENZYL ALCOHOL 50 ML/ML TOPICAL LOTION [ULESFIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BEPREVE 1.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover BEPREVE 1.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | S |
BESIVANCE BESIFLOACIN OPTHALMIC SUSPENSION 0.6% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in ND cover BESIVANCE BESIFLOACIN OPTHALMIC SUSPENSION 0.6% 5 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | S |
BETAGAN 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover BETAGAN 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BETAMETHASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in ND cover BETAMETHASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Betamethasone Dipropionate 0.60mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Betamethasone Dipropionate 0.60mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Betamethasone Dipropionate 0.64mg/g / 45 g TUBE ![Compare how all Medicare Part D PDP plans in ND cover Betamethasone Dipropionate 0.64mg/g / 45 g TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Betamethasone Dipropionate 0.64mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Betamethasone Dipropionate 0.64mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETAMETHASONE DP 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in ND cover BETAMETHASONE DP 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAMETHASONE VA 0.1% LOTION ![Compare how all Medicare Part D PDP plans in ND cover BETAMETHASONE VA 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETAMETHASONE VALERATE CREAM ![Compare how all Medicare Part D PDP plans in ND cover BETAMETHASONE VALERATE CREAM .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETAMETHASONE VALERATE OINTMENT USP ![Compare how all Medicare Part D PDP plans in ND cover BETAMETHASONE VALERATE OINTMENT USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETAPACE 120MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BETAPACE 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BETAPACE 160MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BETAPACE 160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BETAPACE 240MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BETAPACE 240MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BETAPACE AF 80MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BETAPACE AF 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM ![Compare how all Medicare Part D PDP plans in ND cover BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | S |
Betaxolol 20mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Betaxolol 20mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETAXOLOL HCL 0.5% EYE DROP ![Compare how all Medicare Part D PDP plans in ND cover BETAXOLOL HCL 0.5% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETAXOLOL TABLETS 10MG 100 BOT ![Compare how all Medicare Part D PDP plans in ND cover BETAXOLOL TABLETS 10MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETHANECHOL CHLORICDE TABLET ![Compare how all Medicare Part D PDP plans in ND cover BETHANECHOL CHLORICDE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETHANECHOL CHLORIDE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BETHANECHOL CHLORIDE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETHANECHOL CHLORIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BETHANECHOL CHLORIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETHANECHOL CHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in ND cover BETHANECHOL CHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BETIMOL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover BETIMOL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BETIMOL SOLUTION 2.5MG 5 ML BOT ![Compare how all Medicare Part D PDP plans in ND cover BETIMOL SOLUTION 2.5MG 5 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BETOPTIC S OPHTHALMIC SUSPENSION 0.25% 10 ML BOT ![Compare how all Medicare Part D PDP plans in ND cover BETOPTIC S OPHTHALMIC SUSPENSION 0.25% 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
Beyaz 3 BLISTER PACK in 1 PACKAGE / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in ND cover Beyaz 3 BLISTER PACK in 1 PACKAGE / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BIAXIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BIAXIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BIAXIN 250MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in ND cover BIAXIN 250MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BIAXIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BIAXIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BIAXIN XL 500MG TABLET 56 BOX ![Compare how all Medicare Part D PDP plans in ND cover BIAXIN XL 500MG TABLET 56 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BIAXIN XL 500MG TABLET SA ![Compare how all Medicare Part D PDP plans in ND cover BIAXIN XL 500MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BICALUTAMIDE TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in ND cover BICALUTAMIDE TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BICILL LA PFS 600MU 1ML PED ![Compare how all Medicare Part D PDP plans in ND cover BICILL LA PFS 600MU 1ML PED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BICILLIN C-R 1.2MM UNITS SYR 2ML x 10 ![Compare how all Medicare Part D PDP plans in ND cover BICILLIN C-R 1.2MM UNITS SYR 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BICILLIN C-R 900/300 SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in ND cover BICILLIN C-R 900/300 SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BICILLIN LA PFS 1200MU 2ML ![Compare how all Medicare Part D PDP plans in ND cover BICILLIN LA PFS 1200MU 2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BICILLIN LA. 600000UNIT/ML 1ML ![Compare how all Medicare Part D PDP plans in ND cover BICILLIN LA. 600000UNIT/ML 1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BICNU 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in ND cover BICNU 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BIDIL TABLET 20MG/37.5MG ![Compare how all Medicare Part D PDP plans in ND cover BIDIL TABLET 20MG/37.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BILTRICIDE 600MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BILTRICIDE 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BISOPROLOL FUMARATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BISOPROLOL FUMARATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BISOPROLOL FUMARATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BISOPROLOL FUMARATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT) ![Compare how all Medicare Part D PDP plans in ND cover BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BLEOMYCIN SULFATE 30UNITS VIA ![Compare how all Medicare Part D PDP plans in ND cover BLEOMYCIN SULFATE 30UNITS VIA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | P |
BLEPH-10 10% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover BLEPH-10 10% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BLEPHAMIDE 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover BLEPHAMIDE 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BLEPHAMIDE 10-0.2% EYE OINT ![Compare how all Medicare Part D PDP plans in ND cover BLEPHAMIDE 10-0.2% EYE OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BONIVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BONIVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | Q:1 /28Days |
BONIVA 3MG/3ML SYRINGE ![Compare how all Medicare Part D PDP plans in ND cover BONIVA 3MG/3ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | P Q:3 /84Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BOOSTRIX 8; 2.5; 8; 5; 2.5ug/0.5mL; ug/0.5mL; ug/0.5mL; [iU]/0.5mL; [iU]/0.5mL ![Compare how all Medicare Part D PDP plans in ND cover BOOSTRIX 8; 2.5; 8; 5; 2.5ug/0.5mL; ug/0.5mL; ug/0.5mL; [iU]/0.5mL; [iU]/0.5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BOOSTRIX 8; 2.5; 8; 5; 2.5ug/0.5mL; ug/0.5mL; ug/0.5mL; [iU]/0.5mL; [iU]/0.5mL ![Compare how all Medicare Part D PDP plans in ND cover BOOSTRIX 8; 2.5; 8; 5; 2.5ug/0.5mL; ug/0.5mL; ug/0.5mL; [iU]/0.5mL; [iU]/0.5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BOTOX 100UNITS VIAL ![Compare how all Medicare Part D PDP plans in ND cover BOTOX 100UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | P Q:3 /90Days |
BREVICON TABLET 0.5/35 ![Compare how all Medicare Part D PDP plans in ND cover BREVICON TABLET 0.5/35.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | None |
BRIELLYN ![Compare how all Medicare Part D PDP plans in ND cover BRIELLYN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BRILINTA 90mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover BRILINTA 90mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | Q:60 /30Days |
Brimonidine Tartrate 1.5mg/mL ![Compare how all Medicare Part D PDP plans in ND cover Brimonidine Tartrate 1.5mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL ![Compare how all Medicare Part D PDP plans in ND cover BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Bromday 0.9mg/mL ![Compare how all Medicare Part D PDP plans in ND cover Bromday 0.9mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
Bromfenac 1.035mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 2.5 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in ND cover Bromfenac 1.035mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 2.5 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Bromocriptine mesylate 2.5mg/1 24 BOTTLE in 1 CARTON / 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Bromocriptine mesylate 2.5mg/1 24 BOTTLE in 1 CARTON / 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BROMOCRIPTINE MESYLATE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in ND cover BROMOCRIPTINE MESYLATE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUDEPRION SR 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in ND cover BUDEPRION SR 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUDEPRION SR 150MG TABLET SA ![Compare how all Medicare Part D PDP plans in ND cover BUDEPRION SR 150MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUDEPRION XL 300MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in ND cover BUDEPRION XL 300MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUDEPRION XL TABLETS 150MG 500 TABLETS BOT ![Compare how all Medicare Part D PDP plans in ND cover BUDEPRION XL TABLETS 150MG 500 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Budesonide 3mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ND cover Budesonide 3mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUMETANIDE 0.25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in ND cover BUMETANIDE 0.25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUMETANIDE 0.5MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in ND cover BUMETANIDE 0.5MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUMETANIDE 1MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in ND cover BUMETANIDE 1MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUMETANIDE 2MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in ND cover BUMETANIDE 2MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUPHENYL 500MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BUPHENYL 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPHENYL POWDER ![Compare how all Medicare Part D PDP plans in ND cover BUPHENYL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BUPRENEX 0.3MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in ND cover BUPRENEX 0.3MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BUPRENORPHINE 0.3MG/ML SYRN ![Compare how all Medicare Part D PDP plans in ND cover BUPRENORPHINE 0.3MG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Buprenorphine HCl 2mg/1 30 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Buprenorphine HCl 2mg/1 30 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Buprenorphine HCl 8mg/1 30 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Buprenorphine HCl 8mg/1 30 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUPROBAN ER TABLET ![Compare how all Medicare Part D PDP plans in ND cover BUPROBAN ER TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUPROPION HCL 75MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BUPROPION HCL 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUPROPION HCL SR 100 MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BUPROPION HCL SR 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUPROPION HCL SR 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in ND cover BUPROPION HCL SR 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUPROPION HCL TABLET 100MG ![Compare how all Medicare Part D PDP plans in ND cover BUPROPION HCL TABLET 100MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Bupropion Hydrochloride 150mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Bupropion Hydrochloride 150mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUSPIRONE HCL 15MG TABLET (180 CT) ![Compare how all Medicare Part D PDP plans in ND cover BUSPIRONE HCL 15MG TABLET (180 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUSPIRONE HCL 30MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in ND cover BUSPIRONE HCL 30MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUSPIRONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BUSPIRONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUSPIRONE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover BUSPIRONE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUSPIRONE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in ND cover BUSPIRONE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUSULFEX 6mg/mL ![Compare how all Medicare Part D PDP plans in ND cover BUSULFEX 6mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BUTALBITAL/CAFF/APAP/COD CP ![Compare how all Medicare Part D PDP plans in ND cover BUTALBITAL/CAFF/APAP/COD CP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
BUTORPHANOL 10MG/ML SPRAY ![Compare how all Medicare Part D PDP plans in ND cover BUTORPHANOL 10MG/ML SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | Q:5 /28Days |
Butorphanol Tartrate 1mg/mL 10 VIAL in 1 BOX / 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in ND cover Butorphanol Tartrate 1mg/mL 10 VIAL in 1 BOX / 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Butorphanol Tartrate 2mg/mL 10 VIAL in 1 BOX / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in ND cover Butorphanol Tartrate 2mg/mL 10 VIAL in 1 BOX / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$10.00 | $20.00 | None |
Butrans 10ug/h ![Compare how all Medicare Part D PDP plans in ND cover Butrans 10ug/h.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Butrans 20ug/h ![Compare how all Medicare Part D PDP plans in ND cover Butrans 20ug/h.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | Q:4 /28Days |
Butrans 5ug/h ![Compare how all Medicare Part D PDP plans in ND cover Butrans 5ug/h.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$74.00 | $148.00 | Q:4 /28Days |
BYDUREON 2 MG VIAL ![Compare how all Medicare Part D PDP plans in ND cover BYDUREON 2 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | S Q:4 /28Days |
BYETTA 10ug/0.04mL ![Compare how all Medicare Part D PDP plans in ND cover BYETTA 10ug/0.04mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | P Q:2 /28Days |
BYETTA 5MCG/0.02ML PEN INJ ![Compare how all Medicare Part D PDP plans in ND cover BYETTA 5MCG/0.02ML PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | P Q:1 /28Days |
Bystolic 10mg/1 100 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in ND cover Bystolic 10mg/1 100 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
Bystolic 2.5mg/1 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Bystolic 2.5mg/1 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
Bystolic 5mg/1 30 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Bystolic 5mg/1 30 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |
BYSTOLIC TABLETS 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in ND cover BYSTOLIC TABLETS 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$34.00 | $68.00 | None |