2012 Medicare Part D Plan Formulary Information |
Health Net Orange Option 1 (PDP) (S5678-004-0)
Sanctioned Plan
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The Health Net Orange Option 1 (PDP) (S5678-004-0) Formulary Drugs Starting with the Letter R in CMS PDP Region 2 which includes: CT MA RI VT
|
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 VT cover RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | P |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RANEXA 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RANEXA 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | P |
RANEXA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RANEXA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | P |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Ranitidine 15mg/mL ![Compare how all Medicare Part D PDP plans in VT cover Ranitidine 15mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Ranitidine 300mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover Ranitidine 300mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | 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 VT cover RANITIDINE HCL 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
Ranitidine Hydrochloride 300mg/1 30 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover Ranitidine Hydrochloride 300mg/1 30 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RANITIDINE TABLET USP 150MG (500 CT) ![Compare how all Medicare Part D PDP plans in VT cover RANITIDINE TABLET USP 150MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RAPAFLO CAPSULES 4MG 30 BOT ![Compare how all Medicare Part D PDP plans in VT cover RAPAFLO CAPSULES 4MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RAPAFLO CAPSULES 8MG 90 BOT ![Compare how all Medicare Part D PDP plans in VT cover RAPAFLO CAPSULES 8MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RAPAMUNE 1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
RAPAMUNE 2MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
RAPAMUNE TABLETS ![Compare how all Medicare Part D PDP plans in VT cover RAPAMUNE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
RAZADYNE 12MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE 12MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RAZADYNE 4MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RAZADYNE 8MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RAZADYNE ER 16MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE ER 16MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RAZADYNE ER 24MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE ER 24MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RAZADYNE ER 8MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE ER 8MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RAZADYNE SOL 4MG/ML ![Compare how all Medicare Part D PDP plans in VT cover RAZADYNE SOL 4MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REBETOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REBETOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REBETOL 40MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover REBETOL 40MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
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 VT 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 |
25% | 25% | 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 VT 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 |
25% | 25% | P |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in VT cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | P |
RECLAST INJECTION ![Compare how all Medicare Part D PDP plans in VT cover RECLAST INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in VT cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | P |
Rectiv 4mg/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in VT 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) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
REGLAN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REGLAN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
Regonol 5mg/mL 10 AMPULE in 1 CARTON / 2 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in VT 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 |
Injectable Drugs |
25% | 25% | None |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in VT cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RELISTOR 12 MG/0.6 ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover RELISTOR 12 MG/0.6 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
REMERON 15MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REMERON 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REMERON 30MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REMERON 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REMERON 45MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REMERON 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REMERON SLTABLET 15MG TABLET 30 BLPK CRTN ![Compare how all Medicare Part D PDP plans in VT cover REMERON SLTABLET 15MG TABLET 30 BLPK CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REMERON SLTABLET 30MG TABLET 30 TABLET S CRTN ![Compare how all Medicare Part D PDP plans in VT cover REMERON SLTABLET 30MG TABLET 30 TABLET S CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REMERON SLTABLET 45MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REMERON SLTABLET 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMICADE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | P |
REMODULIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REMODULIN 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REMODULIN 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REMODULIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
REPREXAIN 5-200 MG TABLET 100 EA ![Compare how all Medicare Part D PDP plans in VT cover REPREXAIN 5-200 MG TABLET 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
REPREXAIN TABLET ![Compare how all Medicare Part D PDP plans in VT cover REPREXAIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
REQUIP 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REQUIP 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP 1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP 2MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP 3MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP 4MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP 5MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REQUIP 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP XL 2mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT 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 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP XL 4mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT 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 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP XL 6mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT 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 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP XL 8mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT 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 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
REQUIP XL TABLET 12 MG ![Compare how all Medicare Part D PDP plans in VT cover REQUIP XL TABLET 12 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RESCRIPTOR 100mg/1 360 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RESCRIPTOR 100mg/1 360 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RESCRIPTOR 200mg/1 180 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RESCRIPTOR 200mg/1 180 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RESERPINE 0.1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RESERPINE 0.1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RESERPINE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RESERPINE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in VT cover RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RETROVIR 100mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RETROVIR 100mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | 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 VT 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 |
Injectable Drugs |
25% | 25% | None |
RETROVIR 300mg/1 60 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RETROVIR 300mg/1 60 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RETROVIR 50mg/5mL 240 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RETROVIR 50mg/5mL 240 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
Revatio 0.8mg/mL 12.5 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in VT 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 |
25% | 25% | P |
REVATIO 20MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover REVATIO 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | P |
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 VT cover REVLIMID 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REVLIMID 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REVLIMID 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
REYATAZ 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RHEUMATREX 2.5MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VT cover RHEUMATREX 2.5MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RHINOCORT AQUA NASAL SPRAY 32 MCG/SPRAY ![Compare how all Medicare Part D PDP plans in VT cover RHINOCORT AQUA NASAL SPRAY 32 MCG/SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIBASPHERE CAPSULES 200MG 42 BOT ![Compare how all Medicare Part D PDP plans in VT cover RIBASPHERE CAPSULES 200MG 42 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIBAVIRIN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIBAVIRIN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in VT cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIDAURA 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIDAURA 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RIFADIN IV 600MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover RIFADIN IV 600MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in VT cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIFAMPIN 600MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover RIFAMPIN 600MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
RILUTEK 50MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RILUTEK 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
RIMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RIMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RINGERS INJECTION 1000ML BAG ![Compare how all Medicare Part D PDP plans in VT cover RINGERS INJECTION 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in VT cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VT cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RISPERDAL 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 1MG M-TAB ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 1MG M-TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 2MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 3MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL 4MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
RISPERDAL M TABLET 0.5MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL M TABLET 0.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL M-TAB 2mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL M-TAB 2mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL M-TAB 3mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL M-TAB 3mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RISPERDAL M-TAB 4mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in VT cover RISPERDAL M-TAB 4mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
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 VT 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) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Risperidone 1mg/mL 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover Risperidone 1mg/mL 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE TABLET 1 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLET 2 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLET 3 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLET 4 MG ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK ![Compare how all Medicare Part D PDP plans in VT cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RISPERIODONE TABLET ![Compare how all Medicare Part D PDP plans in VT cover RISPERIODONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RITALIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RITALIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITALIN 20MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RITALIN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RITALIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover RITALIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITALIN LA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RITALIN LA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITALIN LA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RITALIN LA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITALIN LA 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RITALIN LA 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITALIN LA 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover RITALIN LA 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITALIN-SR 20MG TABLET SA ![Compare how all Medicare Part D PDP plans in VT cover RITALIN-SR 20MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover RITUXAN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
25% | 25% | None |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
RIVASTIGMINE TARTRATE CAPSULES ![Compare how all Medicare Part D PDP plans in VT cover RIVASTIGMINE TARTRATE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROBAXIN 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover ROBAXIN 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
ROBINUL 0.2MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover ROBINUL 0.2MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
ROBINUL 1MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROBINUL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
ROBINUL FORTE 2MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROBINUL FORTE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
ROCEPHIN FOR INJECTION ![Compare how all Medicare Part D PDP plans in VT cover ROCEPHIN FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Injectable Drugs |
25% | 25% | None |
ROMYCIN 5MG/G OINTMENT ![Compare how all Medicare Part D PDP plans in VT cover ROMYCIN 5MG/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE HCL TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE HYDROCLORIDE TABLET ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE HYDROCLORIDE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE TAB 12MG ER ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE TAB 12MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE TAB 2MG ER ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE TAB 2MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE TAB 4MG ER ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE TAB 4MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE TAB 6MG ER ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE TAB 6MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROPINIROLE TAB 8MG ER ![Compare how all Medicare Part D PDP plans in VT cover ROPINIROLE TAB 8MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in VT cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
Roxicet 325; 5mg/1; mg/1 100 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VT cover Roxicet 325; 5mg/1; mg/1 100 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROXICET 5-325/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VT cover ROXICET 5-325/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
ROXICET 5/500 CAPLET ![Compare how all Medicare Part D PDP plans in VT cover ROXICET 5/500 CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$5.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROZEREM 8MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VT cover ROZEREM 8MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$93.00 | $233.00 | None |
RYTHMOL SR 225mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RYTHMOL SR 225mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RYTHMOL SR 325mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RYTHMOL SR 325mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
RYTHMOL SR 425mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover RYTHMOL SR 425mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |