2013 Medicare Part D Plan Formulary Information |
MCS Classicare B-Max (HMO) (H4006-025-0)
Benefit Details
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The MCS Classicare B-Max (HMO) (H4006-025-0) Formulary Drugs Starting with the Letter E in ADJUNTAS County, PR: CMS MA Region 30 which includes: PR
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Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
E.E.S. 400 FILMTAB ![Compare how all Medicare Part D PDP plans in PR cover E.E.S. 400 FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
E.E.S. GRAN SUS 200/5ML ![Compare how all Medicare Part D PDP plans in PR cover E.E.S. GRAN SUS 200/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in PR cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in PR cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
EFFIENT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EFFIENT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:36 /30Days |
EFFIENT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EFFIENT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:43 /30Days |
Egrifta 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in PR cover Egrifta 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in PR cover ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ELIDEL 1% CREAM ![Compare how all Medicare Part D PDP plans in PR cover ELIDEL 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | S |
ELIGARD 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in PR cover ELIGARD 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIGARD 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in PR cover ELIGARD 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
ELIGARD 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in PR cover ELIGARD 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
ELIGARD 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in PR cover ELIGARD 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ELIQUIS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ELIQUIS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
ELIQUIS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ELIQUIS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
Elitek 3 KIT in 1 CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in PR cover Elitek 3 KIT in 1 CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ELIXOPHYLLIN 80mg/15mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover ELIXOPHYLLIN 80mg/15mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
ELSPAR INJ 10000UNT ![Compare how all Medicare Part D PDP plans in PR cover ELSPAR INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
EMEND 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover EMEND 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:1 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMEND CAPSULES 125MG 6 BLPK ![Compare how all Medicare Part D PDP plans in PR cover EMEND CAPSULES 125MG 6 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:4 /30Days |
EMEND CAPSULES 80MG 2 BLPK ![Compare how all Medicare Part D PDP plans in PR cover EMEND CAPSULES 80MG 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:8 /30Days |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in PR cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:12 /28Days |
Emoquette 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Emoquette 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 |
25% | 25% | Q:28 /28Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in PR cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in PR cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in PR cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Enablex 15mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Enablex 15mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
Enablex 7.5mg EXTENDED RELEASE 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Enablex 7.5mg EXTENDED RELEASE 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
ENALAPRIL MALEATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover ENALAPRIL MALEATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:30 /30Days |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ENBREL 25 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in PR cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ENBREL 50mg/mL ![Compare how all Medicare Part D PDP plans in PR cover ENBREL 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ENDOCET 10/650MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ENDOCET 10/650MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:180 /30Days |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:360 /30Days |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:360 /30Days |
ENDOCET 7.5/500MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ENDOCET 7.5/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:240 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in PR cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P |
ENGERIX B INJECTION 20MCG/ML ![Compare how all Medicare Part D PDP plans in PR cover ENGERIX B INJECTION 20MCG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in PR cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P |
ENOXAPARIN 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /28Days |
ENOXAPARIN 120 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 120 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:24 /28Days |
ENOXAPARIN 150 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 150 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /28Days |
ENOXAPARIN 30 MG/0.3 ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 30 MG/0.3 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:9 /28Days |
ENOXAPARIN 300 MG/3 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 300 MG/3 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENOXAPARIN 40 MG/0.4 ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 40 MG/0.4 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:12 /28Days |
ENOXAPARIN 60 MG/0.6 ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 60 MG/0.6 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:18 /28Days |
ENOXAPARIN 80 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ENOXAPARIN 80 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:25 /28Days |
entacapone 200 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover entacapone 200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Epinastine HCl 0.5mg/mL ![Compare how all Medicare Part D PDP plans in PR cover Epinastine HCl 0.5mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Epinephrine 0.1mg/mL ![Compare how all Medicare Part D PDP plans in PR cover Epinephrine 0.1mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in PR cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:2 /30Days |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in PR cover EPIPEN JR 0.15MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:2 /30Days |
EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPIVIR HBV 100MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EPIVIR HBV 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PR cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
EPIVIR ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover EPIVIR ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Eplerenone 25mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Eplerenone 25mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
Eplerenone 50mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Eplerenone 50mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:60 /30Days |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in PR cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
EPOGEN 3000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in PR cover EPOGEN 3000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in PR cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in PR cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
EPZICOM TABLETS ![Compare how all Medicare Part D PDP plans in PR cover EPZICOM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in PR cover ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ERGOLOID MESYLATES TABLETS 1MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover ERGOLOID MESYLATES TABLETS 1MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
ERRIN 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ERRIN 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in PR cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ERYPED 200 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover ERYPED 200 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in PR cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
ERYTHROCIN TAB 250MG ![Compare how all Medicare Part D PDP plans in PR cover ERYTHROCIN TAB 250MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Erythromycin 2% solution ![Compare how all Medicare Part D PDP plans in PR cover Erythromycin 2% solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Erythromycin 20mg/g 1 TUBE in 1 CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PR cover Erythromycin 20mg/g 1 TUBE in 1 CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN ES 400 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover ERYTHROMYCIN ES 400 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE ![Compare how all Medicare Part D PDP plans in PR cover ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in PR cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESCITALOPRAM 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESCITALOPRAM 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:30 /30Days |
ESCITALOPRAM 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESCITALOPRAM 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:30 /30Days |
ESCITALOPRAM 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESCITALOPRAM 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:30 /30Days |
ESCITALOPRAM OXALATE 5 MG/5 ML ![Compare how all Medicare Part D PDP plans in PR cover ESCITALOPRAM OXALATE 5 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:600 /30Days |
ESTRACE VAG CREAM 0.1MG/GM ![Compare how all Medicare Part D PDP plans in PR cover ESTRACE VAG CREAM 0.1MG/GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
ESTRADIOL .025MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL .025MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:8 /28Days |
ESTRADIOL .0375MG/24 PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL .0375MG/24 PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
ESTRADIOL .075MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL .075MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:8 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK in 1 CARTON / 28 TABLET, FILM C ![Compare how all Medicare Part D PDP plans in PR cover Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK in 1 CARTON / 28 TABLET, FILM C.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL 0.05MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL 0.05MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
ESTRADIOL 0.06MG/24H PATCH TRANSDERMAL WEEKLY ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL 0.06MG/24H PATCH TRANSDERMAL WEEKLY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
ESTRADIOL 0.1MG/DAY PATCH ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL 0.1MG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL VALERATE INJECTION ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL VALERATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in PR cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:1 /90Days |
ESTROPIPATE 0.625(0.75 MG) TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESTROPIPATE 0.625(0.75 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
ESTROPIPATE 1.25(1.5 MG) TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESTROPIPATE 1.25(1.5 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
ESTROPIPATE 2.5 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ESTROPIPATE 2.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in PR cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6 ![Compare how all Medicare Part D PDP plans in PR cover ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days |
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21 ![Compare how all Medicare Part D PDP plans in PR cover ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days |
Ethosuximide 250mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Ethosuximide 250mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in PR cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETIDRONATE DISODIUM 400MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in PR cover ETIDRONATE DISODIUM 400MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETIDRONATE DISODIUM TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in PR cover ETIDRONATE DISODIUM TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Etodolac 300 mg capsule ![Compare how all Medicare Part D PDP plans in PR cover Etodolac 300 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PR cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Etodolac 400mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Etodolac 400mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PR cover ETODOLAC 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Etodolac 500mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Etodolac 500mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PR cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
ETOPOPHOS 100MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ETOPOPHOS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
Etoposide 20mg/mL 1 VIAL in 1 BOX, UNIT-DOSE / 25 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover Etoposide 20mg/mL 1 VIAL in 1 BOX, UNIT-DOSE / 25 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PR cover Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Evista 60mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Evista 60mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
EXELON 13.3 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in PR cover EXELON 13.3 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:30 /30Days |
EXELON 2MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover EXELON 2MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:180 /30Days |
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in PR cover EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:30 /30Days |
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in PR cover EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | P Q:30 /30Days |
Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
EXFORGE 10MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXFORGE 10MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
EXFORGE 10MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXFORGE 10MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
EXFORGE 5MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXFORGE 5MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
EXFORGE 5MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXFORGE 5MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Exforge HCT 10; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Exforge HCT 10; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
Exforge HCT 10; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Exforge HCT 10; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
Exforge HCT 10; 25; 320mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Exforge HCT 10; 25; 320mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
Exforge HCT 5; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Exforge HCT 5; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
Exforge HCT 5; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Exforge HCT 5; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:30 /30Days |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
EXTAVIA 15 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover EXTAVIA 15 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
EXTENDED PHENYTOIN SODIUM CAPSULES 300 MG ![Compare how all Medicare Part D PDP plans in PR cover EXTENDED PHENYTOIN SODIUM CAPSULES 300 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
EXTINA 2% FOAM ![Compare how all Medicare Part D PDP plans in PR cover EXTINA 2% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |