2013 Medicare Part D Plan Formulary Information |
Community Care''s Partnership Program Disabled (HMO SNP) (H2034-002-0)
Benefit Details
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The Community Care''s Partnership Program Disabled (HMO SNP) (H2034-002-0) Formulary Drugs Starting with the Letter C in CALUMET County, WI: CMS MA Region 14 which includes: WI
|
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CABERGOLINE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CABERGOLINE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCIPOTRIENE 0.005% CREAM ![Compare how all Medicare Part D PDP plans in WI cover CALCIPOTRIENE 0.005% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Calcipotriene 50ug/g 60 g in 1 CARTON ![Compare how all Medicare Part D PDP plans in WI cover Calcipotriene 50ug/g 60 g in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCIPOTRIENE TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover CALCIPOTRIENE TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in WI cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCITRIOL 0.25MCG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CALCITRIOL 0.25MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCITRIOL 0.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CALCITRIOL 0.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCITRIOL INJ 1MCG/ML ![Compare how all Medicare Part D PDP plans in WI cover CALCITRIOL INJ 1MCG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in WI cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CAMPATH INJECTION 30 MG/ML ![Compare how all Medicare Part D PDP plans in WI cover CAMPATH INJECTION 30 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Campral 333mg/1 180 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Campral 333mg/1 180 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX ![Compare how all Medicare Part D PDP plans in WI cover CANASA RECTAL SUPPOSITORIES 1000MG 30 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CANCIDAS IV 50MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover CANCIDAS IV 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CANCIDAS IV 70MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover CANCIDAS IV 70MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CAPASTAT SULFATE 1g/1 1 INJECTION, POWDER, FOR SOLUTION in 1 CARTON ![Compare how all Medicare Part D PDP plans in WI cover CAPASTAT SULFATE 1g/1 1 INJECTION, POWDER, FOR SOLUTION in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CAPRELSA 100mg/1 30 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover CAPRELSA 100mg/1 30 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CAPRELSA 300mg/1 30 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover CAPRELSA 300mg/1 30 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CARBAMAZEPINE 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover CARBAMAZEPINE 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carbamazepine 100mg, CHEWABLE 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Carbamazepine 100mg, CHEWABLE 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carbamazepine 100mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Carbamazepine 100mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carbamazepine 200mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Carbamazepine 200mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Carbamazepine 300mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Carbamazepine 300mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBAMAZEPINE TABLET USP 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover CARBAMAZEPINE TABLET USP 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBAMAZEPINE XR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CARBAMAZEPINE XR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBAMAZEPINE XR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CARBAMAZEPINE XR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBIDOPA-LEVODOPA ER 25-100 TAB ![Compare how all Medicare Part D PDP plans in WI cover CARBIDOPA-LEVODOPA ER 25-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBIDOPA-LEVODOPA ER 50-200 TAB ![Compare how all Medicare Part D PDP plans in WI cover CARBIDOPA-LEVODOPA ER 50-200 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBIDOPA/LEVO 10/100 TABLET ![Compare how all Medicare Part D PDP plans in WI cover CARBIDOPA/LEVO 10/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBIDOPA/LEVO 25/100 TABLET ![Compare how all Medicare Part D PDP plans in WI cover CARBIDOPA/LEVO 25/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARBIDOPA/LEVO 25/250 TABLET ![Compare how all Medicare Part D PDP plans in WI cover CARBIDOPA/LEVO 25/250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARIMUNE NF 3GM VIAL ![Compare how all Medicare Part D PDP plans in WI cover CARIMUNE NF 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in WI cover CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CARTIA XT 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in WI cover CARTIA XT 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carvedilol 12.5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Carvedilol 12.5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carvedilol 25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Carvedilol 25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carvedilol 3.125mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Carvedilol 3.125mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Carvedilol 6.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Carvedilol 6.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEENU 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CEENU 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CEENU 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CEENU 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CEENU 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CEENU 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFAZOLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in WI cover CEFAZOLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE ![Compare how all Medicare Part D PDP plans in WI cover Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFAZOLIN 1GM/D5W BAG ![Compare how all Medicare Part D PDP plans in WI cover CEFAZOLIN 1GM/D5W BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFAZOLIN FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover CEFAZOLIN FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in WI cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFEPIME INJ 1GM 20ML APX 10x1G VIAL ![Compare how all Medicare Part D PDP plans in WI cover CEFEPIME INJ 1GM 20ML APX 10x1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFPODOXIME 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover CEFPODOXIME 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFPODOXIME 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CEFPODOXIME 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFPODOXIME 50 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover CEFPODOXIME 50 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT) ![Compare how all Medicare Part D PDP plans in WI cover CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFTRIAXONE 10GM VIAL ![Compare how all Medicare Part D PDP plans in WI cover CEFTRIAXONE 10GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFTRIAXONE 250 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover CEFTRIAXONE 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFTRIAXONE FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover CEFTRIAXONE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFTRIAXONE FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover CEFTRIAXONE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Ceftriaxone Sodium 500mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Ceftriaxone Sodium 500mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
cefuroxime axetil 250mg/1 ![Compare how all Medicare Part D PDP plans in WI cover cefuroxime axetil 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFUROXIME AXETIL 500 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover CEFUROXIME AXETIL 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CELESTONE 0.6MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in WI cover CELESTONE 0.6MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CELLCEPT 200MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover CELLCEPT 200MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CELLCEPT IV INJ 500MG ![Compare how all Medicare Part D PDP plans in WI cover CELLCEPT IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
CELONTIN 300MG KAPSEAL ![Compare how all Medicare Part D PDP plans in WI cover CELONTIN 300MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Cephalexin 125mg/5mL 200 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Cephalexin 125mg/5mL 200 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEPHALEXIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CEPHALEXIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEPHALEXIN 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover CEPHALEXIN 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEPHALEXIN CAPSULES 500MG (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover CEPHALEXIN CAPSULES 500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CEREZYME INJ 200UNIT ![Compare how all Medicare Part D PDP plans in WI cover CEREZYME INJ 200UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CHANTIX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CHANTIX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
CHANTIX 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in WI cover CHANTIX 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
CHANTIX 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CHANTIX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
CHLORDIAZEPOXIDE HCL 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER ![Compare how all Medicare Part D PDP plans in WI cover CHLORDIAZEPOXIDE HCL 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORDIAZEPOXIDE HCL 25mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER ![Compare how all Medicare Part D PDP plans in WI cover CHLORDIAZEPOXIDE HCL 25mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORDIAZEPOXIDE HCL 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER ![Compare how all Medicare Part D PDP plans in WI cover CHLORDIAZEPOXIDE HCL 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH ![Compare how all Medicare Part D PDP plans in WI cover CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORPROMAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CHLORPROMAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORPROMAZINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CHLORPROMAZINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORPROMAZINE 25MG/ML AMP ![Compare how all Medicare Part D PDP plans in WI cover CHLORPROMAZINE 25MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORPROMAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CHLORPROMAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORPROMAZINE HCL 200MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CHLORPROMAZINE HCL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Chlorpromazine Hydrochloride 100mg SUGAR COATED 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Chlorpromazine Hydrochloride 100mg SUGAR COATED 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORTHALIDONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover CHLORTHALIDONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHLORTHALIDONE 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover CHLORTHALIDONE 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in WI cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
cidofovir 375 mg/5 ml vial ![Compare how all Medicare Part D PDP plans in WI cover cidofovir 375 mg/5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Cilostazol 50mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Cilostazol 50mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CILOSTAZOL TABLET 100MG (60 CT) ![Compare how all Medicare Part D PDP plans in WI cover CILOSTAZOL TABLET 100MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Cipro 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in WI cover Cipro 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Cipro 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in WI cover Cipro 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CIPRO HC OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover CIPRO HC OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CIPRO IV INFUSION 200MG 100ML BAG ![Compare how all Medicare Part D PDP plans in WI cover CIPRO IV INFUSION 200MG 100ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CIPROFLOXACIN 0.3% EYE DROP ![Compare how all Medicare Part D PDP plans in WI cover CIPROFLOXACIN 0.3% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CIPROFLOXACIN 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover CIPROFLOXACIN 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ciprofloxacin 400mg/40mL 1 VIAL in 1 CARTON / 40 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover Ciprofloxacin 400mg/40mL 1 VIAL in 1 CARTON / 40 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CIPROFLOXACIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CIPROFLOXACIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Ciprofloxacin and Dextrose 2mg/mL 24 BAG in 1 CASE / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in WI cover Ciprofloxacin and Dextrose 2mg/mL 24 BAG in 1 CASE / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CIPROFLOXACIN HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CIPROFLOXACIN HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CIPROFLOXACIN TABLETS 750MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover CIPROFLOXACIN TABLETS 750MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CITALOPRAM HBR 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CITALOPRAM HBR 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in WI cover CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CITOLOPRAM HBR 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover CITOLOPRAM HBR 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLARINEX 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CLARINEX 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CLARITHROMYCIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CLARITHROMYCIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLARITHROMYCIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CLARITHROMYCIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLARITHROMYCIN ER 500MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLARITHROMYCIN ER 500MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLARITHROMYCIN FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover CLARITHROMYCIN FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLARITHROMYCIN FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover CLARITHROMYCIN FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLEMASTINE FUM 2.68MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CLEMASTINE FUM 2.68MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLEOCIN 100MG VAGINAL OVULE ![Compare how all Medicare Part D PDP plans in WI cover CLEOCIN 100MG VAGINAL OVULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CLINDAMYCIN 150MG/ML ADDVAN ![Compare how all Medicare Part D PDP plans in WI cover CLINDAMYCIN 150MG/ML ADDVAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINDAMYCIN HCL 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CLINDAMYCIN HCL 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINDAMYCIN HYDROCHLORIDE CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover CLINDAMYCIN HYDROCHLORIDE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in WI cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
clindamycin phosphate 10mg/mL 1 BOTTLE in 1 CARTON / 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover clindamycin phosphate 10mg/mL 1 BOTTLE in 1 CARTON / 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in WI cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN PHOSPHATE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in WI cover CLINDAMYCIN PHOSPHATE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
clindamycin-d5w 300 mg/50 ml ![Compare how all Medicare Part D PDP plans in WI cover clindamycin-d5w 300 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
clindamycin-d5w 600 mg/50 ml ![Compare how all Medicare Part D PDP plans in WI cover clindamycin-d5w 600 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
clindamycin-d5w 900 mg/50 ml ![Compare how all Medicare Part D PDP plans in WI cover clindamycin-d5w 900 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINIMIX 4.25/10 SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover CLINIMIX 4.25/10 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINIMIX 4.25/20 SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover CLINIMIX 4.25/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLINIMIX 4.25/25 SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover CLINIMIX 4.25/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOBETASOL E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WI cover CLOBETASOL E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clobetasol Propionate 0.4625mg/mL 1 BOTTLE in 1 CARTON / 50 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Clobetasol Propionate 0.4625mg/mL 1 BOTTLE in 1 CARTON / 50 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOMIPRAMINE HCL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CLOMIPRAMINE HCL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOMIPRAMINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CLOMIPRAMINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOMIPRAMINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CLOMIPRAMINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonazepam 0.125mg/1 10 BLISTER PACK in 1 CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC ![Compare how all Medicare Part D PDP plans in WI cover Clonazepam 0.125mg/1 10 BLISTER PACK in 1 CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonazepam 0.25mg/1 10 BLISTER PACK in 1 CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Clonazepam 0.25mg/1 10 BLISTER PACK in 1 CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonazepam 0.5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Clonazepam 0.5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonazepam 1mg/1 90 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Clonazepam 1mg/1 90 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonazepam 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Clonazepam 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonidine 0.1mg/d 4 POUCH in 1 CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in WI cover Clonidine 0.1mg/d 4 POUCH in 1 CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonidine 0.2mg/d 4 POUCH in 1 CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in WI cover Clonidine 0.2mg/d 4 POUCH in 1 CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clonidine 0.3mg/d 4 POUCH in 1 CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in WI cover Clonidine 0.3mg/d 4 POUCH in 1 CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLONIDINE HCL 0.2MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLONIDINE HCL 0.2MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLONIDINE HCL TABLET 0.1MG (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLONIDINE HCL TABLET 0.1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLONIDINE HCL TABLET 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLONIDINE HCL TABLET 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOPIDOGREL TAB 75MG ![Compare how all Medicare Part D PDP plans in WI cover CLOPIDOGREL TAB 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
CLORAZEPATE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CLORAZEPATE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clorazepate Dipotassium 3.75mg/1 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Clorazepate Dipotassium 3.75mg/1 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Clorazepate Dipotassium 7.5mg/1 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Clorazepate Dipotassium 7.5mg/1 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOTRIMAZOLE 10MG TROCHE ![Compare how all Medicare Part D PDP plans in WI cover CLOTRIMAZOLE 10MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL ![Compare how all Medicare Part D PDP plans in WI cover CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Clozapine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Clozapine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOZAPINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLOZAPINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOZAPINE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLOZAPINE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CLOZAPINE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover CLOZAPINE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CODEINE SULFATE 30 MG TABLET 3100 ![Compare how all Medicare Part D PDP plans in WI cover CODEINE SULFATE 30 MG TABLET 3100.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Codeine sulfate 60mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Codeine sulfate 60mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CODEINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover CODEINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
COLCRYS 0.6 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover COLCRYS 0.6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
colistimethate 150mg/2mL 1 VIAL in 1 CARTON / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover colistimethate 150mg/2mL 1 VIAL in 1 CARTON / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Colyte with flavor packs 240; 2.98; 6.72; 5.84; 22.72g/4L; g/4L; g/4L; g/4L; g/4L ![Compare how all Medicare Part D PDP plans in WI cover Colyte with flavor packs 240; 2.98; 6.72; 5.84; 22.72g/4L; g/4L; g/4L; g/4L; g/4L.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COMBIGAN 0.2%-0.5% DROPS ![Compare how all Medicare Part D PDP plans in WI cover COMBIGAN 0.2%-0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMBIVENT INHALER ![Compare how all Medicare Part D PDP plans in WI cover COMBIVENT INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMETRIQ 100 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in WI cover COMETRIQ 100 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMETRIQ 140 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in WI cover COMETRIQ 140 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMETRIQ 60 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in WI cover COMETRIQ 60 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in WI cover COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMTAN 200MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover COMTAN 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COMVAX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in WI cover COMVAX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in WI cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | P |
CRESTOR 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CRESTOR 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CRESTOR 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CRESTOR 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CRESTOR 40mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover CRESTOR 40mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CRESTOR 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover CRESTOR 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CRIXIVAN 400mg/1 90 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover CRIXIVAN 400mg/1 90 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CROMOLYN NEBULIZER SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover CROMOLYN NEBULIZER SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in WI cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Cyclafem 1/35 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Cyclafem 1/35 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Cyclafem 7/7/7 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Cyclafem 7/7/7 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
Cyclobenzaprine Hydrochloride 5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Cyclobenzaprine Hydrochloride 5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | None |
CYCLOSET TABLETS ![Compare how all Medicare Part D PDP plans in WI cover CYCLOSET TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
Cyclosporine 100mg/1 30 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Cyclosporine 100mg/1 30 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
Cyclosporine 25mg/1 30 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Cyclosporine 25mg/1 30 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
Cyclosporine 50mg/1 30 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Cyclosporine 50mg/1 30 BLISTER PACK in 1 CARTON / 1 CAPSULE, LIQUID FILLED in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
Cyclosporine 50mg/mL 10 VIAL in 1 BOX / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover Cyclosporine 50mg/mL 10 VIAL in 1 BOX / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in WI cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
N/A | N/A | P |
CYKLOKAPRON 100MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in WI cover CYKLOKAPRON 100MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CYMBALTA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CYMBALTA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Cymbalta 60mg/1 1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Cymbalta 60mg/1 1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYSTADANE POWDER FOR ORAL SOLUTION 180GM ![Compare how all Medicare Part D PDP plans in WI cover CYSTADANE POWDER FOR ORAL SOLUTION 180GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
N/A | N/A | None |