2012 Medicare Part D Plan Formulary Information |
Humana Complete (PDP) (S5884-040-0)
Benefit Details
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The Humana Complete (PDP) (S5884-040-0) Formulary Drugs Starting with the Letter G in CMS PDP Region 12 which includes: AL TN
|
Drugs Starting with Letter G
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
GABAPENTIN 100mg/1 ![Compare how all Medicare Part D PDP plans in AL cover GABAPENTIN 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | Q:270 /30Days |
Gabapentin 250mg/5mL 470 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Gabapentin 250mg/5mL 470 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GABAPENTIN 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GABAPENTIN 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | Q:270 /30Days |
GABAPENTIN 600MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GABAPENTIN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | Q:180 /30Days |
GABAPENTIN CAPSULES 300MG ![Compare how all Medicare Part D PDP plans in AL cover GABAPENTIN CAPSULES 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | Q:270 /30Days |
GABAPENTIN TABLET 800MG ![Compare how all Medicare Part D PDP plans in AL cover GABAPENTIN TABLET 800MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | Q:180 /30Days |
GABITRIL 12MG FILMTAB ![Compare how all Medicare Part D PDP plans in AL cover GABITRIL 12MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | Q:120 /30Days |
GABITRIL 16mg/1 ![Compare how all Medicare Part D PDP plans in AL cover GABITRIL 16mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | Q:90 /30Days |
GABITRIL 2mg/1 ![Compare how all Medicare Part D PDP plans in AL cover GABITRIL 2mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | Q:90 /30Days |
GABITRIL 4mg/1 ![Compare how all Medicare Part D PDP plans in AL cover GABITRIL 4mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Galantamine 12mg/1 60 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Galantamine 12mg/1 60 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
Galantamine 4mg/1 60 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Galantamine 4mg/1 60 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
Galantamine 8mg/1 60 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Galantamine 8mg/1 60 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 16MG 30 BOT ![Compare how all Medicare Part D PDP plans in AL cover GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 16MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:30 /30Days |
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 24MG 30 BOT ![Compare how all Medicare Part D PDP plans in AL cover GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 24MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:30 /30Days |
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 8MG 30 BOT ![Compare how all Medicare Part D PDP plans in AL cover GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 8MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:30 /30Days |
Galantamine Hydrobromide Oral Solution 4mg/mL 100 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Galantamine Hydrobromide Oral Solution 4mg/mL 100 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:200 /30Days |
GAMASTAN S/D INJECTION 16.5GM/2ML VIALGL ![Compare how all Medicare Part D PDP plans in AL cover GAMASTAN S/D INJECTION 16.5GM/2ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | P |
GAMMAGARD LIQUID 100mg/mL 1 BOTTLE, GLASS in 1 CARTON / 25 mL in 1 BOTTLE, GLASS ![Compare how all Medicare Part D PDP plans in AL cover GAMMAGARD LIQUID 100mg/mL 1 BOTTLE, GLASS in 1 CARTON / 25 mL in 1 BOTTLE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
GAMMAPLEX INJECTION 5 GM/100 ML ![Compare how all Medicare Part D PDP plans in AL cover GAMMAPLEX INJECTION 5 GM/100 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in AL cover Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GANCICLOVIR 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GANCICLOVIR 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GANCICLOVIR 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GANCICLOVIR 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GANCICLOVIR FOR INJECTION ![Compare how all Medicare Part D PDP plans in AL cover GANCICLOVIR FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GARDASIL VIAL ![Compare how all Medicare Part D PDP plans in AL cover GARDASIL VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | Q:3 /365Days |
GASTROCROM 100MG/5ML CONC ![Compare how all Medicare Part D PDP plans in AL cover GASTROCROM 100MG/5ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GaviLyte - C TM 240; 2.98; 6.72; 5.84; 22.72g/278.26g; g/278.26g; g/278.26g; g/278.26g; g/278.26g 27 ![Compare how all Medicare Part D PDP plans in AL cover GaviLyte - C TM 240; 2.98; 6.72; 5.84; 22.72g/278.26g; g/278.26g; g/278.26g; g/278.26g; g/278.26g 27.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GaviLyte - N 420; 1.48; 5.72; 11.2g/438.4g; g/438.4g; g/438.4g; g/438.4g 438.4 g in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover GaviLyte - N 420; 1.48; 5.72; 11.2g/438.4g; g/438.4g; g/438.4g; g/438.4g 438.4 g in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GaviLyte G TM 236; 2.97; 6.74; 5.86; 22.74g/274.31g; g/274.31g; g/274.31g; g/274.31g; g/274.31g 274. ![Compare how all Medicare Part D PDP plans in AL cover GaviLyte G TM 236; 2.97; 6.74; 5.86; 22.74g/274.31g; g/274.31g; g/274.31g; g/274.31g; g/274.31g 274..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GELNIQUE 100mg/g 30 PACKET in 1 CARTON / 1 g in 1 PACKET ![Compare how all Medicare Part D PDP plans in AL cover GELNIQUE 100mg/g 30 PACKET in 1 CARTON / 1 g in 1 PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | Q:30 /30Days |
Gemcitabine 38mg/mL 1 VIAL, SINGLE-USE in 1 CARTON / 26.3 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in AL cover Gemcitabine 38mg/mL 1 VIAL, SINGLE-USE in 1 CARTON / 26.3 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
Gemcitabine Hydrochloride 1g/25mL ![Compare how all Medicare Part D PDP plans in AL cover Gemcitabine Hydrochloride 1g/25mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GEMFIBROZIL TABLET 600MG (500 CT) ![Compare how all Medicare Part D PDP plans in AL cover GEMFIBROZIL TABLET 600MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | Q:60 /30Days |
GEMZAR 1GRAM VIAL ![Compare how all Medicare Part D PDP plans in AL cover GEMZAR 1GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
GENGRAF 100MG CAPSULE U.D. ![Compare how all Medicare Part D PDP plans in AL cover GENGRAF 100MG CAPSULE U.D..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | P |
GENGRAF 100MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in AL cover GENGRAF 100MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | P |
GENGRAF 25MG CAPSULE U.D. ![Compare how all Medicare Part D PDP plans in AL cover GENGRAF 25MG CAPSULE U.D..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | P |
GENTAK 3MG/GM EYE OINTMENT ![Compare how all Medicare Part D PDP plans in AL cover GENTAK 3MG/GM EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GENTAMICIN 100MG/NS 100ML ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN 100MG/NS 100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GENTAMICIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GENTAMICIN 60MG/NS 50ML PB ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN 60MG/NS 50ML PB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GENTAMICIN 70MG/NS 50ML PB ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN 70MG/NS 50ML PB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GENTAMICIN 80MG/NS 50ML PB ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN 80MG/NS 50ML PB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GENTAMICIN 90MG/NS 100ML PB ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN 90MG/NS 100ML PB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
Gentamicin Sulfate 40mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 2 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in AL cover Gentamicin Sulfate 40mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 2 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GENTAMICIN SULFATE CREAM USP 0.1% 15GM TUBE ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN SULFATE CREAM USP 0.1% 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GENTAMICIN SULFATE OINTMENT USP 0.1% 15GM TUBE ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN SULFATE OINTMENT USP 0.1% 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GENTAMICIN SULFATE OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in AL cover GENTAMICIN SULFATE OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GENTASOL 3MG/ML EYE DROPS ![Compare how all Medicare Part D PDP plans in AL cover GENTASOL 3MG/ML EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GEODON 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GEODON 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
GEODON 20MG VIAL ![Compare how all Medicare Part D PDP plans in AL cover GEODON 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GEODON 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GEODON 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
GEODON 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GEODON 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
GEODON 80MG CAPSULE ![Compare how all Medicare Part D PDP plans in AL cover GEODON 80MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GIANVI 3 MG-0.02 MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GIANVI 3 MG-0.02 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLASSIA 1g/50mL 1 VIAL, GLASS in 1 CARTON / 50 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in AL cover GLASSIA 1g/50mL 1 VIAL, GLASS in 1 CARTON / 50 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P |
GLEEVEC 100MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLEEVEC 100MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P Q:180 /30Days |
GLEEVEC 400MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLEEVEC 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier Drugs |
33% | N/A | P Q:60 /30Days |
GLIMEPIRIDE 1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLIMEPIRIDE 1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIMEPIRIDE 2MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLIMEPIRIDE 2MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIMEPIRIDE 4MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLIMEPIRIDE 4MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIPIZIDE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLIPIZIDE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIPIZIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLIPIZIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
Glipizide and Metformin Hydrochloride 2.5; 250mg/1; mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Glipizide and Metformin Hydrochloride 2.5; 250mg/1; mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
Glipizide and Metformin Hydrochloride 5; 500mg/1; mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Glipizide and Metformin Hydrochloride 5; 500mg/1; mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in AL cover GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIPIZIDE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in AL cover GLIPIZIDE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIPIZIDE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in AL cover GLIPIZIDE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLIPIZIDE-METFORMIN 2.5-500MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLIPIZIDE-METFORMIN 2.5-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLUCAGEN 1MG HYPOKIT ![Compare how all Medicare Part D PDP plans in AL cover GLUCAGEN 1MG HYPOKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLUCAGON 1MG EMERGENCY KIT ![Compare how all Medicare Part D PDP plans in AL cover GLUCAGON 1MG EMERGENCY KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GLUCOTROL 10MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLUCOTROL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLUCOTROL 5MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLUCOTROL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLUCOTROL XL 10MG TABLET SA ![Compare how all Medicare Part D PDP plans in AL cover GLUCOTROL XL 10MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLUCOTROL XL 2.5MG TABLET SA ![Compare how all Medicare Part D PDP plans in AL cover GLUCOTROL XL 2.5MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLUCOTROL XL 5MG TABLET SA ![Compare how all Medicare Part D PDP plans in AL cover GLUCOTROL XL 5MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GLUMETZA ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLUMETZA ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | Q:120 /30Days |
GLYBURIDE 2.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE 2.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
Glyburide 6mg/1 500 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in AL cover Glyburide 6mg/1 500 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE AND METFORMIN HCL 1.25-250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE AND METFORMIN HCL 1.25-250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE MICRO 3MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE MICRO 3MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE MICRONIZED 1.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE MICRONIZED 1.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE TABLETS ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE TABLETS ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE-METFORMIN HCL 2.5-500MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE-METFORMIN HCL 2.5-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYBURIDE-METFORMIN HCL 5MG-500MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYBURIDE-METFORMIN HCL 5MG-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYCOPYRROLATE 0.2MG/ML VL ![Compare how all Medicare Part D PDP plans in AL cover GLYCOPYRROLATE 0.2MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GLYCOPYRROLATE TABLET 1MG (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYCOPYRROLATE TABLET 1MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GLYCOPYRROLATE TABLET 2MG (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYCOPYRROLATE TABLET 2MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GLYCRON 1.5MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYCRON 1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYCRON 3MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYCRON 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYCRON 4.5MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYCRON 4.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYCRON 6MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYCRON 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GLYNASE 1.5MG PRESTAB ![Compare how all Medicare Part D PDP plans in AL cover GLYNASE 1.5MG PRESTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLYNASE PRESTAB TABLET 3MG (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYNASE PRESTAB TABLET 3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLYNASE PRESTAB TABLET 6MG (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GLYNASE PRESTAB TABLET 6MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLYSET 100MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYSET 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GLYSET 25MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYSET 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GLYSET 50MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GLYSET 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GOLYTELY PACKET 227.1 GM/2.82 GM ![Compare how all Medicare Part D PDP plans in AL cover GOLYTELY PACKET 227.1 GM/2.82 GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GOLYTELY SOLUTION 236 GM/2.97 GM/6 GM ![Compare how all Medicare Part D PDP plans in AL cover GOLYTELY SOLUTION 236 GM/2.97 GM/6 GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
Gralise 300mg/1 30 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Gralise 300mg/1 30 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | S Q:30 /30Days |
Gralise 600mg/1 90 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AL cover Gralise 600mg/1 90 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | S Q:90 /30Days |
Gralise Starter Pack 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in AL cover Gralise Starter Pack 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | S Q:78 /30Days |
GRANISETRON HCL 1MG TABLET (20 CT) ![Compare how all Medicare Part D PDP plans in AL cover GRANISETRON HCL 1MG TABLET (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | P Q:28 /28Days |
Granisetron Hydrochloride 0.1mg/mL 10 VIAL, GLASS in 1 CARTON / 1 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in AL cover Granisetron Hydrochloride 0.1mg/mL 10 VIAL, GLASS in 1 CARTON / 1 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
Granisetron Hydrochloride 1mg/mL 10 VIAL, SINGLE-USE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in AL cover Granisetron Hydrochloride 1mg/mL 10 VIAL, SINGLE-USE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | Q:4 /28Days |
Granisol 2mg/10mL 1 BOTTLE, GLASS in 1 CARTON / 30 mL in 1 BOTTLE, GLASS ![Compare how all Medicare Part D PDP plans in AL cover Granisol 2mg/10mL 1 BOTTLE, GLASS in 1 CARTON / 30 mL in 1 BOTTLE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | P Q:150 /28Days |
GRIFULVIN V 500MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GRIFULVIN V 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
GRIS-PEG 125MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GRIS-PEG 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GRIS-PEG 250 MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GRIS-PEG 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand Drugs |
$70.00 | $200.00 | None |
GRISEOFULVIN ORAL SUSPENSION 125MG/5ML 4 FLOZ CTR ![Compare how all Medicare Part D PDP plans in AL cover GRISEOFULVIN ORAL SUSPENSION 125MG/5ML 4 FLOZ CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GUANABENZ ACETATE 4MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GUANABENZ ACETATE 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand Drugs |
$36.00 | $98.00 | None |
GUANFACINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GUANFACINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GUANFACINE 2MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AL cover GUANFACINE 2MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |
GUANIDINE HCL 125MG TABLET ![Compare how all Medicare Part D PDP plans in AL cover GUANIDINE HCL 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic Drugs |
$4.00 | $0.00 | None |