2012 Medicare Part D Plan Formulary Information |
Humana Gold Choice H8145-138 (PFFS) (H8145-138-0)
Benefit Details
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The Humana Gold Choice H8145-138 (PFFS) (H8145-138-0) Formulary Drugs Starting with the Letter F in MCINTOSH County, ND: CMS MA Region 19 which includes: ND
|
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 ND cover FABRAZYME 35MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P |
FACTIVE 320mg/1 7 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in ND cover FACTIVE 320mg/1 7 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FAMCICLOVIR 125MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FAMCICLOVIR 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FAMCICLOVIR 250MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FAMCICLOVIR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FAMCICLOVIR 500MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FAMCICLOVIR 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FAMOTIDINE 20MG PIGGYBACK ![Compare how all Medicare Part D PDP plans in ND cover FAMOTIDINE 20MG PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FAMOTIDINE 20MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in ND cover FAMOTIDINE 20MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FAMOTIDINE 40MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FAMOTIDINE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FAMOTIDINE FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in ND cover FAMOTIDINE FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD ![Compare how all Medicare Part D PDP plans in ND cover FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 1 KIT in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 1 KIT in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 10mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 10mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 12mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 12mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 1mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 1mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 2mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 2mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 4mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 4mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 6mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 6mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FANAPT 8mg/1 60 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FANAPT 8mg/1 60 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:60 /30Days |
FARESTON 60MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FARESTON 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:30 /30Days |
FASLODEX INJECTION ![Compare how all Medicare Part D PDP plans in ND cover FASLODEX INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:30 /30Days |
FazaClo 100mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FazaClo 100mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FazaClo 12.5mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FazaClo 12.5mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | S |
FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | S |
FazaClo 25mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FazaClo 25mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | S |
FAZACLO TABLETS ORALLY DISINTEGRATING ![Compare how all Medicare Part D PDP plans in ND cover FAZACLO TABLETS ORALLY DISINTEGRATING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | S |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FELBAMATE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FELBAMATE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FELBAMATE 600 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in ND cover FELBAMATE 600 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FELBATOL 400MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FELBATOL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FELBATOL 600MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FELBATOL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FELBATOL 600MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in ND cover FELBATOL 600MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FELODIPINE ER 2.5MG TABLET 90 TABLET BOT ![Compare how all Medicare Part D PDP plans in ND cover FELODIPINE ER 2.5MG TABLET 90 TABLET BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELODIPINE TABLET ER 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in ND cover FELODIPINE TABLET ER 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:30 /30Days |
FELODIPINE TABLET ER 5MG (1000 CT) ![Compare how all Medicare Part D PDP plans in ND cover FELODIPINE TABLET ER 5MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:30 /30Days |
FEMARA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FEMARA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:30 /30Days |
FEMCON Fe 72 CARTON in 1 CASE / 5 CELLO PACK in 1 CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT ![Compare how all Medicare Part D PDP plans in ND cover FEMCON Fe 72 CARTON in 1 CASE / 5 CELLO PACK in 1 CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FEMHRT 0.5MG/2.5MCG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FEMHRT 0.5MG/2.5MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FEMHRT 1/5 TABLET ![Compare how all Medicare Part D PDP plans in ND cover FEMHRT 1/5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FEMRING 0.05MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in ND cover FEMRING 0.05MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:1 /90Days |
FEMRING 0.10MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in ND cover FEMRING 0.10MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:1 /90Days |
FEMTRACE 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FEMTRACE 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FEMTRACE 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FEMTRACE 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FEMTRACE 1.8MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FEMTRACE 1.8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOFIBRATE 134MG CAPSULE ![Compare how all Medicare Part D PDP plans in ND cover FENOFIBRATE 134MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:30 /30Days |
FENOFIBRATE 160mg/1 90 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover FENOFIBRATE 160mg/1 90 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:30 /30Days |
FENOFIBRATE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in ND cover FENOFIBRATE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:30 /30Days |
FENOFIBRATE 54MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FENOFIBRATE 54MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FENOFIBRATE 67MG CAPSULE ![Compare how all Medicare Part D PDP plans in ND cover FENOFIBRATE 67MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FENOPROFEN 600MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FENOPROFEN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:20 /30Days |
FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:20 /30Days |
FENTANYL 75 MCG/HR PATCH ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL 75 MCG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:20 /30Days |
FENTANYL CITRATE 1600ug/1 30 BLISTER PACK in 1 CARTON / 1 LOZENGE in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE 1600ug/1 30 BLISTER PACK in 1 CARTON / 1 LOZENGE in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:120 /30Days |
FENTANYL CITRATE INJECTION 50MCG 10 X 2ML CTG ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE INJECTION 50MCG 10 X 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:120 /30Days |
FENTANYL CITRATE OTFC 200 MCG ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL CITRATE OTFC 200 MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:120 /30Days |
FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:20 /30Days |
FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in ND cover FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:20 /30Days |
FINASTERIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FINASTERIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | Q:30 /30Days |
Firazyr 30.0mg/3mL 1 SYRINGE, GLASS in 1 CARTON / 3 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in ND cover Firazyr 30.0mg/3mL 1 SYRINGE, GLASS in 1 CARTON / 3 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P Q:9 /30Days |
FIRMAGON 20mg/mL 1 VIAL, GLASS in 1 CARTON / 4 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in ND cover FIRMAGON 20mg/mL 1 VIAL, GLASS in 1 CARTON / 4 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:4 /28Days |
FLAREX 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover FLAREX 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLAVOXATE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLAVOXATE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FLECAINIDE ACETATE 100 MG TAB #60 EA ![Compare how all Medicare Part D PDP plans in ND cover FLECAINIDE ACETATE 100 MG TAB #60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FLECAINIDE ACETATE 150 MG TAB 360 EA ![Compare how all Medicare Part D PDP plans in ND cover FLECAINIDE ACETATE 150 MG TAB 360 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FLECAINIDE ACETATE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover FLECAINIDE ACETATE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FLECTOR PATCH ![Compare how all Medicare Part D PDP plans in ND cover FLECTOR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:60 /30Days |
FLONASE 0.05% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in ND cover FLONASE 0.05% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:16 /30Days |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in ND cover FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in ND cover FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in ND cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in ND cover FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:24 /30Days |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in ND cover FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:24 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in ND cover FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:11 /30Days |
Fluconazole 200mg/1 30 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Fluconazole 200mg/1 30 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fluconazole 50mg/1 30 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Fluconazole 50mg/1 30 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR ![Compare how all Medicare Part D PDP plans in ND cover FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUCONAZOLE ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in ND cover FLUCONAZOLE ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUCONAZOLE ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in ND cover FLUCONAZOLE ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUCONAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in ND cover FLUCONAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUCONAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in ND cover FLUCONAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | Q:4 /28Days |
Flucytosine 250mg/1 ![Compare how all Medicare Part D PDP plans in ND cover Flucytosine 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Flucytosine 500mg/1 ![Compare how all Medicare Part D PDP plans in ND cover Flucytosine 500mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FLUDARA FOR INJECTION 50 MG/VIAL ![Compare how all Medicare Part D PDP plans in ND cover FLUDARA FOR INJECTION 50 MG/VIAL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUDARABINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in ND cover FLUDARABINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | P |
FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in ND cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:50 /30Days |
FLUOCINOLONE 0.01% BODY OIL ![Compare how all Medicare Part D PDP plans in ND cover FLUOCINOLONE 0.01% BODY OIL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.01% CREAM ![Compare how all Medicare Part D PDP plans in ND cover FLUOCINOLONE 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.01% SOLUTION ![Compare how all Medicare Part D PDP plans in ND cover FLUOCINOLONE 0.01% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.025% CREAM ![Compare how all Medicare Part D PDP plans in ND cover FLUOCINOLONE 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.025% OINTMENT ![Compare how all Medicare Part D PDP plans in ND cover FLUOCINOLONE 0.025% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in ND cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fluocinonide 0.5mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover Fluocinonide 0.5mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fluocinonide 0.5mg/g 1 TUBE in 1 CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover Fluocinonide 0.5mg/g 1 TUBE in 1 CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Fluocinonide 0.5mg/g 1 TUBE in 1 CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover Fluocinonide 0.5mg/g 1 TUBE in 1 CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOROMETHOLONE 0.1% DROPS ![Compare how all Medicare Part D PDP plans in ND cover FLUOROMETHOLONE 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOROPLEX 1% CREAM ![Compare how all Medicare Part D PDP plans in ND cover FLUOROPLEX 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FLUOROURACIL 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in ND cover FLUOROURACIL 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FLUOROURACIL 5% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in ND cover FLUOROURACIL 5% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Fluorouracil 50mg/mL ![Compare how all Medicare Part D PDP plans in ND cover Fluorouracil 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | P |
FLUOROURACIL CREA 5% ![Compare how all Medicare Part D PDP plans in ND cover FLUOROURACIL CREA 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ND cover Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOXETINE 40MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in ND cover FLUOXETINE 40MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | Q:60 /30Days |
FLUOXETINE CAPSULES 10MG (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover FLUOXETINE CAPSULES 10MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | Q:60 /30Days |
FLUOXETINE DR 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in ND cover FLUOXETINE DR 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:4 /28Days |
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 ND cover FLUOXETINE HCL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fluoxetine Hydrochloride 20mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Fluoxetine Hydrochloride 20mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | Q:120 /30Days |
FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT ![Compare how all Medicare Part D PDP plans in ND cover FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUOXYMESTERONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLUOXYMESTERONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FLUPHENAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUPHENAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUPHENAZINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUPHENAZINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fluphenazine Decanoate 25mg/mL ![Compare how all Medicare Part D PDP plans in ND cover Fluphenazine Decanoate 25mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR ![Compare how all Medicare Part D PDP plans in ND cover FLUPHENAZINE HCL 2.5MG/5ML ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLURBIPROFEN 0.03% EYE DROP ![Compare how all Medicare Part D PDP plans in ND cover FLURBIPROFEN 0.03% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Flurbiprofen 100mg/1 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ND cover Flurbiprofen 100mg/1 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLURBIPROFEN 50MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLURBIPROFEN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Flutamide 125mg/1 500 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Flutamide 125mg/1 500 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Fluticasone Propionate 0.05mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover Fluticasone Propionate 0.05mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fluticasone Propionate 0.5mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in ND cover Fluticasone Propionate 0.5mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in ND cover FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | Q:16 /30Days |
FLUVASTATIN SODIUM 20 MG CAP ![Compare how all Medicare Part D PDP plans in ND cover FLUVASTATIN SODIUM 20 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FLUVASTATIN SODIUM 40 MG CAP ![Compare how all Medicare Part D PDP plans in ND cover FLUVASTATIN SODIUM 40 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FLUVOXAMINE MALEATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FLUVOXAMINE MALEATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUVOXAMINE MALEATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in ND cover FLUVOXAMINE MALEATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:90 /30Days |
Fluvoxamine maleate 50mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in ND cover Fluvoxamine maleate 50mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:90 /30Days |
FML FORTE 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in ND cover FML FORTE 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FML LIQUIFILM 0.1% EYE DROP ![Compare how all Medicare Part D PDP plans in ND cover FML LIQUIFILM 0.1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FML S.O.P. 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in ND cover FML S.O.P. 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FOLOTYN 20mg/mL 1 VIAL, SINGLE-USE in 1 CARTON / 2 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in ND cover FOLOTYN 20mg/mL 1 VIAL, SINGLE-USE in 1 CARTON / 2 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | None |
Fomepizole 1g/mL 1 VIAL in 1 CARTON / 1.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in ND cover Fomepizole 1g/mL 1 VIAL in 1 CARTON / 1.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fondaparinux Sodium 10mg/0.8mL 2 SYRINGE in 1 CARTON / 0.8 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in ND cover Fondaparinux Sodium 10mg/0.8mL 2 SYRINGE in 1 CARTON / 0.8 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Fondaparinux Sodium 2.5mg/0.5mL 2 SYRINGE in 1 CARTON / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in ND cover Fondaparinux Sodium 2.5mg/0.5mL 2 SYRINGE in 1 CARTON / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Fondaparinux Sodium 5mg/4mL 2 SYRINGE in 1 CARTON / 0.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in ND cover Fondaparinux Sodium 5mg/4mL 2 SYRINGE in 1 CARTON / 0.4 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Fondaparinux Sodium 7.5mg/0.6mL 2 SYRINGE in 1 CARTON / 0.6 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in ND cover Fondaparinux Sodium 7.5mg/0.6mL 2 SYRINGE in 1 CARTON / 0.6 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FORADIL AEROLIZER 12 MCG CAP ![Compare how all Medicare Part D PDP plans in ND cover FORADIL AEROLIZER 12 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | Q:60 /30Days |
FORTAZ 2GM VIAL ![Compare how all Medicare Part D PDP plans in ND cover FORTAZ 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FORTAZ 6GM VIAL ![Compare how all Medicare Part D PDP plans in ND cover FORTAZ 6GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FORTAZ/ISO-OSMOT 2GM/50ML ![Compare how all Medicare Part D PDP plans in ND cover FORTAZ/ISO-OSMOT 2GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
FORTAZ/ISO-OSMOTIC 1GM/50ML ![Compare how all Medicare Part D PDP plans in ND cover FORTAZ/ISO-OSMOTIC 1GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | None |
Forteo 250ug/mL 1 SYRINGE in 1 CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in ND cover Forteo 250ug/mL 1 SYRINGE in 1 CARTON / 2.4 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | S Q:2 /28Days |
FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in ND cover FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P Q:4 /28Days |
FOSCARNET 24MG/ML INFUS BTTL ![Compare how all Medicare Part D PDP plans in ND cover FOSCARNET 24MG/ML INFUS BTTL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P |
FOSINOPRIL SODIUM 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in ND cover FOSINOPRIL SODIUM 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FOSINOPRIL SODIUM 20MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FOSINOPRIL SODIUM 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FOSINOPRIL SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FOSINOPRIL SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE TABLETS 10;12.5 MG;MG ![Compare how all Medicare Part D PDP plans in ND cover FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE TABLETS 10;12.5 MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE TABLETS 20;12.5 MG;MG ![Compare how all Medicare Part D PDP plans in ND cover FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE TABLETS 20;12.5 MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $80.00 | None |
Fosphenytoin 50mg/mL ![Compare how all Medicare Part D PDP plans in ND cover Fosphenytoin 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
Fragmin 12500[iU]/0.5mL ![Compare how all Medicare Part D PDP plans in ND cover Fragmin 12500[iU]/0.5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Fragmin 15000[iU]/0.6mL ![Compare how all Medicare Part D PDP plans in ND cover Fragmin 15000[iU]/0.6mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Fragmin 18000[iU]/0.72mL ![Compare how all Medicare Part D PDP plans in ND cover Fragmin 18000[iU]/0.72mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1 ![Compare how all Medicare Part D PDP plans in ND cover FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:2 /30Days |
FRAGMIN 2500UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in ND cover FRAGMIN 2500UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
FRAGMIN 5000UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in ND cover FRAGMIN 5000UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
FRAGMIN INJECTION 10000UNITS 1 X 10 SYR ![Compare how all Medicare Part D PDP plans in ND cover FRAGMIN INJECTION 10000UNITS 1 X 10 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
FRAGMIN INJECTION 7500UNT/ML ![Compare how all Medicare Part D PDP plans in ND cover FRAGMIN INJECTION 7500UNT/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | Q:14 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FREAMINE III INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in ND cover FREAMINE III INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P |
FREAMINE III INJECTION WITH ELECTROLYTES 3% ![Compare how all Medicare Part D PDP plans in ND cover FREAMINE III INJECTION WITH ELECTROLYTES 3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P |
Furosemide 10mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 4 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in ND cover Furosemide 10mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 4 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FUROSEMIDE 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in ND cover FUROSEMIDE 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FUROSEMIDE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in ND cover FUROSEMIDE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FUROSEMIDE 40MG TABLET ![Compare how all Medicare Part D PDP plans in ND cover FUROSEMIDE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in ND cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FUROSEMIDE 80MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in ND cover FUROSEMIDE 80MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.00 | $0.00 | None |
FUSILEV I.V. 50 MG VIAL ![Compare how all Medicare Part D PDP plans in ND cover FUSILEV I.V. 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$65.00 | $185.00 | P |
FUZEON CONVENIENCE KIT ![Compare how all Medicare Part D PDP plans in ND cover FUZEON CONVENIENCE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
26% | N/A | Q:60 /30Days |