2012 Medicare Part D Plan Formulary Information |
United American - Preferred (PDP) (S5755-011-0)
Benefit Details
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The United American - Preferred (PDP) (S5755-011-0) Formulary Drugs Starting with the Letter H in CMS PDP Region 8 which includes: NC
|
Drugs Starting with Letter H
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Halaven 0.5mg/mL ![Compare how all Medicare Part D PDP plans in NC cover Halaven 0.5mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
31% | 31% | None |
HALDOL DECANOATE INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HALDOL DECANOATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HALDOL DECANOATE INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HALDOL DECANOATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HALDOL INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HALDOL INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HalfLytely and Bisacodyl Bowel Prep with Flavor Packs 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in NC cover HalfLytely and Bisacodyl Bowel Prep with Flavor Packs 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:6 /90Days |
Halobetasol Propionate 0.5mg/g 1 TUBE in 1 CARTON / 50 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NC cover Halobetasol Propionate 0.5mg/g 1 TUBE in 1 CARTON / 50 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
halobetasol propionate 0.5mg/g 50 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NC cover halobetasol propionate 0.5mg/g 50 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HALOPERIDOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HALOPERIDOL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HALOPERIDOL 1MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HALOPERIDOL 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HALOPERIDOL 2MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL 2MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HALOPERIDOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HALOPERIDOL DEC 100MG/ML VL ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL DEC 100MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HALOPERIDOL DEC 50MG 10 X 1ML PKG ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL DEC 50MG 10 X 1ML PKG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HALOPERIDOL LAC 2MG/ML CONC ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL LAC 2MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HALOPERIDOL LAC 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HALOPERIDOL LAC 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HAVRIX HEPATITIS A VACCINE INACTIVATED INJECTION SOLUTION 1440UNITS 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in NC cover HAVRIX HEPATITIS A VACCINE INACTIVATED INJECTION SOLUTION 1440UNITS 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HAVRIX HEPATITIS A VACCINE INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HAVRIX HEPATITIS A VACCINE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HECTOROL 0.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in NC cover HECTOROL 0.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
HECTOROL 2.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in NC cover HECTOROL 2.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Hectorol 4ug/2mL ![Compare how all Medicare Part D PDP plans in NC cover Hectorol 4ug/2mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
HEPARIN 25000U-1/2NS 250ML ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN 25000U-1/2NS 250ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HEPARIN 25000U-1/2NS 500ML ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN 25000U-1/2NS 500ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HEPARIN NA 2000UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN NA 2000UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Heparin Sodium in Dextrose 5; 4000g/100mL; [USP'U]/100mL 24 CONTAINER in 1 CASE / 500 mL in 1 CONTA ![Compare how all Medicare Part D PDP plans in NC cover Heparin Sodium in Dextrose 5; 4000g/100mL; [USP'U]/100mL 24 CONTAINER in 1 CASE / 500 mL in 1 CONTA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HEPARIN SODIUM INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN SODIUM INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HEPARIN SODIUM INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN SODIUM INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HEPARIN SODIUM INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN SODIUM INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HEPARIN SODIUM INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN SODIUM INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HEPARIN SODIUM INJECTION SOLUTION 200UNITS 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in NC cover HEPARIN SODIUM INJECTION SOLUTION 200UNITS 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HEPATAMINE INJECTION 8% ![Compare how all Medicare Part D PDP plans in NC cover HEPATAMINE INJECTION 8%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HEPATASOL INJECTION 8% 500ML BAG ![Compare how all Medicare Part D PDP plans in NC cover HEPATASOL INJECTION 8% 500ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | None |
HEPATITIS B VACCINE RECOMBIANT ADULT FORMULATION INJECTION 10MCG 1ML VIALSD ![Compare how all Medicare Part D PDP plans in NC cover HEPATITIS B VACCINE RECOMBIANT ADULT FORMULATION INJECTION 10MCG 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | P |
HEPSERA 10MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HEPSERA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
31% | 31% | Q:90 /90Days |
HERCEPTIN 440MG VIAL ![Compare how all Medicare Part D PDP plans in NC cover HERCEPTIN 440MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand Drugs |
$95.00 | $190.00 | None |
HEXALEN CAPSULES ![Compare how all Medicare Part D PDP plans in NC cover HEXALEN CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
31% | 31% | None |
HIZENTRA LIQUID ![Compare how all Medicare Part D PDP plans in NC cover HIZENTRA LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
31% | 31% | P |
HUMALOG 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMALOG 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMALOG KWIKPEN INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HUMALOG KWIKPEN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMALOG MIX 50/50 VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMALOG MIX 50/50 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMALOG MIX 75/25 VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMALOG MIX 75/25 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMALOG MIX KWIKPEN INJECTION ![Compare how all Medicare Part D PDP plans in NC cover HUMALOG MIX KWIKPEN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HUMALOG MIX KWIKPEN INJECTION SUSPENSION ![Compare how all Medicare Part D PDP plans in NC cover HUMALOG MIX KWIKPEN INJECTION SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
Humira 2 KIT in 1 CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in NC cover Humira 2 KIT in 1 CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
31% | 31% | P Q:5 /90Days |
HUMIRA PEN KIT 40MG-70% 1 PKGCOM ![Compare how all Medicare Part D PDP plans in NC cover HUMIRA PEN KIT 40MG-70% 1 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier Drugs |
31% | 31% | P |
HUMULIN 70/30 PEN INJECTION 100UNT 1 X 3.0ML(PEN) CTG ![Compare how all Medicare Part D PDP plans in NC cover HUMULIN 70/30 PEN INJECTION 100UNT 1 X 3.0ML(PEN) CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMULIN 70/30 VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMULIN 70/30 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMULIN N 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMULIN N 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMULIN N PEN INJECTION 100UNT 1 X 3.0ML (PEN) CTG ![Compare how all Medicare Part D PDP plans in NC cover HUMULIN N PEN INJECTION 100UNT 1 X 3.0ML (PEN) CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMULIN R 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMULIN R 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HUMULIN R 500U/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HUMULIN R 500U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand Drugs |
$45.00 | $90.00 | Q:60 /30Days |
HYDRALAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDRALAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDRALAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDRALAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDRALAZINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDRALAZINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDRALAZINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDRALAZINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDRALAZINE HYDROCHLORIDE INJECTION USP ![Compare how all Medicare Part D PDP plans in NC cover HYDRALAZINE HYDROCHLORIDE INJECTION USP .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCHLORIDE 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROCHLORIDE 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCHLOROTHIAZIDE 12.5MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROCHLOROTHIAZIDE 12.5MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HYDROCHLOROTHIAZIDE 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCHLOROTHIAZIDE 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCHLOROTHIAZIDE 25 MG / TRIAMTERENE 50 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in NC cover HYDROCHLOROTHIAZIDE 25 MG / TRIAMTERENE 50 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCHLOROTHIAZIDE TABLETS 25MG ![Compare how all Medicare Part D PDP plans in NC cover HYDROCHLOROTHIAZIDE TABLETS 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
Hydrocodone Bitartrate and Acetaminophen 300; 10mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in NC cover Hydrocodone Bitartrate and Acetaminophen 300; 10mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Hydrocodone Bitartrate and Acetaminophen 300; 5mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in NC cover Hydrocodone Bitartrate and Acetaminophen 300; 5mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Hydrocodone Bitartrate and Acetaminophen 300; 7.5mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in NC cover Hydrocodone Bitartrate and Acetaminophen 300; 7.5mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Hydrocodone Bitartrate and Acetaminophen 325; 7.5mg/15mL; mg/15mL ![Compare how all Medicare Part D PDP plans in NC cover Hydrocodone Bitartrate and Acetaminophen 325; 7.5mg/15mL; mg/15mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Hydrocodone Bitartrate And Acetaminophen 500; 7.5mg/1; mg/1 500 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NC cover Hydrocodone Bitartrate And Acetaminophen 500; 7.5mg/1; mg/1 500 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE BITARTRATE AND ACETAMINOPHEN ORAL SOLUTION 500;7;7.5MG/15ML;% 4 FLO BOT ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE BITARTRATE AND ACETAMINOPHEN ORAL SOLUTION 500;7;7.5MG/15ML;% 4 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE BITARTRATE AND ACETAMINOPHEN TABLET 7.5-650MG (500 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE BITARTRATE AND ACETAMINOPHEN TABLET 7.5-650MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE BITARTRATE AND IBUPROFEN TABLET 7.5-200MG (100 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE BITARTRATE AND IBUPROFEN TABLET 7.5-200MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE-ACETAMINOPHEN 10-750MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE-ACETAMINOPHEN 10-750MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE-ACETAMINOPHEN 10MG-500MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE-ACETAMINOPHEN 10MG-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE-ACETAMINOPHEN 10MG-650MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE-ACETAMINOPHEN 10MG-650MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE-ACETAMINOPHEN 5MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE-ACETAMINOPHEN 5MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE-ACETAMINOPHEN 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE-ACETAMINOPHEN 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE/APAP 10/325 TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE/APAP 10/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROCODONE/APAP 10/660 TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE/APAP 10/660 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE/APAP 2.5/500 TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE/APAP 2.5/500 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE/APAP 5/500 TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE/APAP 5/500 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCODONE/APAP 7.5/750 TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCODONE/APAP 7.5/750 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE 0.2% CREAM ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE 0.2% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE 0.2% OINTMENT ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE 0.2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Hydrocortisone 100mg/60mL 7 BOTTLE, WITH APPLICATOR in 1 BOX / 60 mL in 1 BOTTLE, WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in NC cover Hydrocortisone 100mg/60mL 7 BOTTLE, WITH APPLICATOR in 1 BOX / 60 mL in 1 BOTTLE, WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Hydrocortisone 20mg/1 100 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NC cover Hydrocortisone 20mg/1 100 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
Hydrocortisone 25mg/g 1 TUBE in 1 TUBE / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NC cover Hydrocortisone 25mg/g 1 TUBE in 1 TUBE / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HYDROCORTISONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROCORTISONE AND ACETIC ACID OTIC SOLUTION ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE AND ACETIC ACID OTIC SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE BUTYRATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE BUTYRATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE BUTYRATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE BUTYRATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE BUTYRATE 0.1% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE BUTYRATE 0.1% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE CREAM 1% 1 LB JAR ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE CREAM 1% 1 LB JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE LOTION 2.5% 2 OZ BOT ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE LOTION 2.5% 2 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROCORTISONE OINTMENT 1% 1 LB JAR ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE OINTMENT 1% 1 LB JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HYDROCORTISONE OINTMENT USP 2.5% 20GM TUBE BOX ![Compare how all Medicare Part D PDP plans in NC cover HYDROCORTISONE OINTMENT USP 2.5% 20GM TUBE BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic Drugs |
$3.00 | $0.00 | None |
HYDROMORPHONE HCL 8MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROMORPHONE HCL 8MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Hydromorphone Hydrochloride 10mg/mL 1 VIAL in 1 CARTON / 50 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NC cover Hydromorphone Hydrochloride 10mg/mL 1 VIAL in 1 CARTON / 50 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROMORPHONE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in NC cover HYDROMORPHONE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROMORPHONE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in NC cover HYDROMORPHONE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYCHLOROQUINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYCHLOROQUINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYUREA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYUREA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYZINE 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYZINE 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYZINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYZINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYZINE HCL 10MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYZINE HCL 10MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYZINE HCL 10MG/5ML ORAL SOLUTION 1 PT BOT ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYZINE HCL 10MG/5ML ORAL SOLUTION 1 PT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYZINE HCL 25MG TABLET ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYZINE HCL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |
HYDROXYZINE HCL TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in NC cover HYDROXYZINE HCL TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Non-Preferred Generic Drugs |
$9.00 | $21.00 | None |