2012 Medicare Part D Plan Formulary Information |
CIGNA Medicare Rx Plan Two (PDP) (S5617-195-0)
Benefit Details
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The CIGNA Medicare Rx Plan Two (PDP) (S5617-195-0) Formulary Drugs Starting with the Letter R in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL ![Compare how all Medicare Part D PDP plans in MN cover RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:60 /30Days |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RANEXA 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RANEXA 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RANEXA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RANEXA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
Ranitidine 15mg/mL ![Compare how all Medicare Part D PDP plans in MN cover Ranitidine 15mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
Ranitidine 300mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover Ranitidine 300mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RANITIDINE HCL 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover RANITIDINE HCL 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
Ranitidine Hydrochloride 300mg/1 30 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover Ranitidine Hydrochloride 300mg/1 30 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RANITIDINE TABLET USP 150MG (500 CT) ![Compare how all Medicare Part D PDP plans in MN cover RANITIDINE TABLET USP 150MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RAPAFLO CAPSULES 4MG 30 BOT ![Compare how all Medicare Part D PDP plans in MN cover RAPAFLO CAPSULES 4MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | S Q:30 /30Days |
RAPAFLO CAPSULES 8MG 90 BOT ![Compare how all Medicare Part D PDP plans in MN cover RAPAFLO CAPSULES 8MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | S Q:30 /30Days |
RAPAMUNE 1MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RAPAMUNE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in MN cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
RAPAMUNE 2MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RAPAMUNE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
RAPAMUNE TABLETS ![Compare how all Medicare Part D PDP plans in MN cover RAPAMUNE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | P |
REBETOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover REBETOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
REBETOL 40MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MN cover REBETOL 40MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REBIF 22ug/0.5mL 12 SYRINGE, GLASS in 1 CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in MN cover REBIF 22ug/0.5mL 12 SYRINGE, GLASS in 1 CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REBIF 44ug/0.5mL 12 SYRINGE, GLASS in 1 CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in MN cover REBIF 44ug/0.5mL 12 SYRINGE, GLASS in 1 CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in MN cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in MN cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | P |
Rectiv 4mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MN cover Rectiv 4mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
Regonol 5mg/mL 10 AMPULE in 1 CARTON / 2 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in MN cover Regonol 5mg/mL 10 AMPULE in 1 CARTON / 2 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in MN cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P Q:30 /30Days |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in MN cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | Q:120 /365Days |
RELISTOR 12 MG/0.6 ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover RELISTOR 12 MG/0.6 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover REMICADE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REMODULIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover REMODULIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REMODULIN 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover REMODULIN 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REMODULIN 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover REMODULIN 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REMODULIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REPREXAIN 5-200 MG TABLET 100 EA ![Compare how all Medicare Part D PDP plans in MN cover REPREXAIN 5-200 MG TABLET 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
REPREXAIN TABLET ![Compare how all Medicare Part D PDP plans in MN cover REPREXAIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
REPREXAIN TABLET ![Compare how all Medicare Part D PDP plans in MN cover REPREXAIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
REQUIP XL 2mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover REQUIP XL 2mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REQUIP XL 4mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover REQUIP XL 4mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REQUIP XL 6mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover REQUIP XL 6mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REQUIP XL 8mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover REQUIP XL 8mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REQUIP XL TABLET 12 MG ![Compare how all Medicare Part D PDP plans in MN cover REQUIP XL TABLET 12 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RESCRIPTOR 100mg/1 360 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover RESCRIPTOR 100mg/1 360 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RESCRIPTOR 200mg/1 180 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover RESCRIPTOR 200mg/1 180 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RESERPINE 0.1MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RESERPINE 0.1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RESERPINE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RESERPINE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in MN cover RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RETROVIR 10mg/mL 10 VIAL, SINGLE-USE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in MN cover RETROVIR 10mg/mL 10 VIAL, SINGLE-USE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
Revatio 0.8mg/mL 12.5 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in MN cover Revatio 0.8mg/mL 12.5 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REVATIO 20MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover REVATIO 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
REVIA 50MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover REVIA 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVLIMID 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in MN cover REVLIMID 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in MN cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
REVLIMID 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in MN cover REVLIMID 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
REVLIMID 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
REYATAZ 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover REYATAZ 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RHEUMATREX 2.5MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in MN cover RHEUMATREX 2.5MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RIBASPHERE 400MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIBASPHERE 600MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
RIBASPHERE CAPSULES 200MG 42 BOT ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE CAPSULES 200MG 42 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RIBASPHERE RibaPak ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE RibaPak .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
RIBASPHERE RibaPak 400mg/1 ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE RibaPak 400mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
RIBASPHERE RibaPak 600mg/1 ![Compare how all Medicare Part D PDP plans in MN cover RIBASPHERE RibaPak 600mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
RIBAVIRIN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RIBAVIRIN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in MN cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RIDAURA 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RIDAURA 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RIFAMATE CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RIFAMATE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in MN cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIFAMPIN 600MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover RIFAMPIN 600MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RIFATER TABLET ![Compare how all Medicare Part D PDP plans in MN cover RIFATER TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
RILUTEK 50MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RILUTEK 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RIMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover RIMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
RINGERS INJECTION 1000ML BAG ![Compare how all Medicare Part D PDP plans in MN cover RINGERS INJECTION 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in MN cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in MN cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in MN cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in MN cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in MN cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | None |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in MN cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Risperidone 1mg/1 7 BLISTER PACK in 1 CARTON / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in MN cover Risperidone 1mg/1 7 BLISTER PACK in 1 CARTON / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
Risperidone 1mg/mL 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover Risperidone 1mg/mL 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:360 /30Days |
RISPERIDONE TABLET ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIDONE TABLET 1 MG ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIDONE TABLET 2 MG ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIDONE TABLET 3 MG ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIDONE TABLET 4 MG ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:120 /30Days |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:120 /30Days |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK ![Compare how all Medicare Part D PDP plans in MN cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RISPERIODONE TABLET ![Compare how all Medicare Part D PDP plans in MN cover RISPERIODONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:90 /30Days |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover RITUXAN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
33% | 33% | P |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in MN cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:60 /30Days |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in MN cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:60 /30Days |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in MN cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:60 /30Days |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in MN cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | Q:60 /30Days |
ROBAXIN 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover ROBAXIN 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
ROMYCIN 5MG/G OINTMENT ![Compare how all Medicare Part D PDP plans in MN cover ROMYCIN 5MG/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE HCL TABLET ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HCL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE HYDROCLORIDE TABLET ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE HYDROCLORIDE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE TAB 12MG ER ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE TAB 12MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE TAB 2MG ER ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE TAB 2MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE TAB 4MG ER ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE TAB 4MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE TAB 6MG ER ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE TAB 6MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROPINIROLE TAB 8MG ER ![Compare how all Medicare Part D PDP plans in MN cover ROPINIROLE TAB 8MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in MN cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$41.00 | $102.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Roxicet 325; 5mg/1; mg/1 100 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MN cover Roxicet 325; 5mg/1; mg/1 100 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROXICET 5-325/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in MN cover ROXICET 5-325/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROXICET 5/500 CAPLET ![Compare how all Medicare Part D PDP plans in MN cover ROXICET 5/500 CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic Drugs |
$5.00 | $12.50 | None |
ROXICODONE 15MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover ROXICODONE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |
ROXICODONE 30MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover ROXICODONE 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$85.00 | $212.50 | None |