2013 Medicare Part D Plan Formulary Information |
Windsor Medicare Extra Diabetes Plan (HMO SNP) (H5698-155-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Diabetes Plan (HMO SNP). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Windsor Medicare Extra Diabetes Plan (HMO SNP) (H5698-155-0) Formulary Drugs Starting with the Letter A in YAZOO County, MS: CMS MA Region 16 which includes: MS
|
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
A-HYDROCORT 100MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover A-HYDROCORT 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ABILIFY 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
ABILIFY 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
ABILIFY 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:900 /30Days |
ABILIFY 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
ABILIFY 2MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
ABILIFY 30MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
ABILIFY 5MG TABLET (OTSUKA) ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY 5MG TABLET (OTSUKA).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
ABILIFY DISCMELT 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY DISCMELT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABILIFY DISCMELT 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY DISCMELT 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:60 /30Days |
ABILIFY INJ 9.75MG ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY INJ 9.75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:4 /1Days |
ABILIFY MAINTENA ER 300 MG VL ![Compare how all Medicare Part D PDP plans in MS cover ABILIFY MAINTENA ER 300 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Acarbose 100mg/1 1000 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Acarbose 100mg/1 1000 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
Acarbose 50mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Acarbose 50mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ACARBOSE TABLETS ![Compare how all Medicare Part D PDP plans in MS cover ACARBOSE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ACEBUTOLOL 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ACEBUTOLOL 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ACEBUTOLOL 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ACEBUTOLOL 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ACELLULAR PERTUSSIS VACCINE 50 UNT/ML / DIPHTHERIA TOXOID VACCINE 50 UNT/ML / TETANUS TOXOID VACCINE ![Compare how all Medicare Part D PDP plans in MS cover ACELLULAR PERTUSSIS VACCINE 50 UNT/ML / DIPHTHERIA TOXOID VACCINE 50 UNT/ML / TETANUS TOXOID VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Acetaminophen and Codeine Phosphate 300; 60mg/1; mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Acetaminophen and Codeine Phosphate 300; 60mg/1; mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:390 /30Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE SOLUTION ORAL USP 120;12MG/5ML;MG/ 12.5 ML CUPUD ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN AND CODEINE PHOSPHATE SOLUTION ORAL USP 120;12MG/5ML;MG/ 12.5 ML CUPUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:5000 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:390 /30Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:390 /30Days |
ACETASOL HC SOLUTION 10ML 10 ML BOT ![Compare how all Medicare Part D PDP plans in MS cover ACETASOL HC SOLUTION 10ML 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ACETIC ACID 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in MS cover ACETIC ACID 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN ![Compare how all Medicare Part D PDP plans in MS cover ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
ACTEMRA INJECTION 200MG/10ML ![Compare how all Medicare Part D PDP plans in MS cover ACTEMRA INJECTION 200MG/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ACTHIB VACCINE VIAL 10-24UNT/5ML ![Compare how all Medicare Part D PDP plans in MS cover ACTHIB VACCINE VIAL 10-24UNT/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
ACTIMMUNE SOLUTION FOR INJECTION 100MCG ![Compare how all Medicare Part D PDP plans in MS cover ACTIMMUNE SOLUTION FOR INJECTION 100MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTOS 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTOS 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Actos 30mg/90 Tablet Bottle ![Compare how all Medicare Part D PDP plans in MS cover Actos 30mg/90 Tablet Bottle.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
ACTOS 45MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACTOS 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
ACYCLOVIR 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
Acyclovir 200mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Acyclovir 200mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
acyclovir 400mg/1 ![Compare how all Medicare Part D PDP plans in MS cover acyclovir 400mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
acyclovir 5% ointment ![Compare how all Medicare Part D PDP plans in MS cover acyclovir 5% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ACYCLOVIR SODIUM 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACYCLOVIR SODIUM 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in MS cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Adalat CC 30mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Adalat CC 30mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
Adalat CC 60mg/1 1000 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Adalat CC 60mg/1 1000 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ADALAT CC 90MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ADALAT CC 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in MS cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:2 /28Days |
ADCIRCA TABLETS 20MG 60 BOT ![Compare how all Medicare Part D PDP plans in MS cover ADCIRCA TABLETS 20MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:12 /30Days |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:12 /30Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in MS cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:12 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Afinitor 7.5mg/1 28 BLISTER PACK in 1 CARTON / 1 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Afinitor 7.5mg/1 28 BLISTER PACK in 1 CARTON / 1 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
AFINITOR TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
AFINITOR TABLETS 2.5 MG ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR TABLETS 2.5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
AK-CON 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover AK-CON 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AKNE-MYCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in MS cover AKNE-MYCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ALBENZA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALBENZA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH in 1 CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH in 1 CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P Q:360 /30Days |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P Q:60 /30Days |
ALBUTEROL SULFATE SOLUTION FOR INHALATION ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE SOLUTION FOR INHALATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P Q:360 /30Days |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ALBUTEROL SULFATE TABLET 2MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL SULFATE TABLET 2MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ALBUTEROL TABLET 4MG (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover ALBUTEROL TABLET 4MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ALDACTAZIDE 50/50 TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALDACTAZIDE 50/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ALENDRONATE SODIUM 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:240 /30Days |
ALENDRONATE SODIUM 70mg/1 ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 70mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:4 /28Days |
ALENDRONATE SODIUM TABLET 35MG 20 CRTN ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM TABLET 35MG 20 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:4 /28Days |
ALFUZOSIN HYDROCHLORIDE 10mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover ALFUZOSIN HYDROCHLORIDE 10mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
ALIMTA 500MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ALIMTA 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ALINIA 100MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MS cover ALINIA 100MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ALLOPURINOL TABLETS ![Compare how all Medicare Part D PDP plans in MS cover ALLOPURINOL TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ALPRAZOLAM 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALPRAZOLAM 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:90 /30Days |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:90 /30Days |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:150 /30Days |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AMANTADINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMANTADINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Amantadine Hydrochloride 50mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amantadine Hydrochloride 50mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
AMIFOSTINE 50mg/mL 3 VIAL, SINGLE-USE in 1 CARTON / 10 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in MS cover AMIFOSTINE 50mg/mL 3 VIAL, SINGLE-USE in 1 CARTON / 10 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
AMILORIDE HCL W/HCTZ 5MG-50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMILORIDE HCL W/HCTZ 5MG-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
Aminophylline 25mg/mL 5 TRAY in 1 CARTON / 5 AMPULE in 1 TRAY / 10 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in MS cover Aminophylline 25mg/mL 5 TRAY in 1 CARTON / 5 AMPULE in 1 TRAY / 10 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMINOSYN HBC INJECTION SULFITE FREE 7% ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN HBC INJECTION SULFITE FREE 7%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMINOSYN II 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN II 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMINOSYN II 8.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN II 8.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
Aminosyn II Sulfite-Free 1490; 1527; 1050; 1107; 750; 450; 990; 1500; 1575; 258; 405; 447; 1083; 79 ![Compare how all Medicare Part D PDP plans in MS cover Aminosyn II Sulfite-Free 1490; 1527; 1050; 1107; 750; 450; 990; 1500; 1575; 258; 405; 447; 1083; 79.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
AMIODARONE HCL 200MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL 200MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMIODARONE HCL INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in MS cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITRIP/PERPHEN 10-2 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 10-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITRIP/PERPHEN 25-2 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 25-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITRIP/PERPHEN 25-4 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 25-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMITRIPTYLINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMITRIPTYLINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMITRIPTYLINE HCL 150 MG TAB ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 150 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMITRIPTYLINE HCL 25MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 25MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMITRIPTYLINE HCL 75MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL 75MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover AMITRIPTYLINE HCL TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMLODIPINE BESYLATE 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE 2.5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMLODIPINE BESYLATE 5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE 5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE CAPSULES ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE CAPSULES ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ammonium lactate 12% cream ![Compare how all Medicare Part D PDP plans in MS cover ammonium lactate 12% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in MS cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
amox tr-k clv 200-28.5/5 susp ![Compare how all Medicare Part D PDP plans in MS cover amox tr-k clv 200-28.5/5 susp.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOX TR-K CLV 500-125 MG TAB ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-K CLV 500-125 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXICILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amoxicillin 250mg/1 500 TABLET, CHEWABLE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amoxicillin 250mg/1 500 TABLET, CHEWABLE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXICILLIN 50 MG/ML / CLAVULANATE 12.5 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 50 MG/ML / CLAVULANATE 12.5 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
Amoxicillin 500mg/1 500 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Amoxicillin 500mg/1 500 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMOXICILLIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
AMPHETAMINE SALT COMBO 30MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
AMPHETAMINE SALTS 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALTS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
AMPHETAMINE SALTS 5 MG TAB ![Compare how all Medicare Part D PDP plans in MS cover AMPHETAMINE SALTS 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMPICILLIN CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AMPICILLIN POWDER FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN POWDER FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPYRA ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMPYRA ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:60 /30Days |
Amturnide 150; 5; 12.5mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amturnide 150; 5; 12.5mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Amturnide 300; 10; 12.5mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amturnide 300; 10; 12.5mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Amturnide 300; 10; 25mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amturnide 300; 10; 25mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Amturnide 300; 5; 12.5mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amturnide 300; 5; 12.5mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Amturnide 300; 5; 25mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Amturnide 300; 5; 25mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Anastrozole 1mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Anastrozole 1mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ANDROGEL 1%(50MG) GEL PACKET ![Compare how all Medicare Part D PDP plans in MS cover ANDROGEL 1%(50MG) GEL PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | P |
ANTARA CAPSULES ![Compare how all Medicare Part D PDP plans in MS cover ANTARA CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANTARA CAPSULES ![Compare how all Medicare Part D PDP plans in MS cover ANTARA CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in MS cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 10 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in MS cover Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 10 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in MS cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:28 /28Days |
APRISO CP24 ![Compare how all Medicare Part D PDP plans in MS cover APRISO CP24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:120 /30Days |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in MS cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Aralast NP 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in MS cover Aralast NP 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in MS cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ARZERRA 20mg/mL 3 VIAL in 1 CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARZERRA 20mg/mL 3 VIAL in 1 CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASACOL 400mg/1 12 BOTTLE CASE / 180 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover ASACOL 400mg/1 12 BOTTLE CASE / 180 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:180 /30Days |
Ascomp with Codeine 325; 50; 40; 30mg/1; mg/1; mg/1; mg/1 500 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Ascomp with Codeine 325; 50; 40; 30mg/1; mg/1; mg/1; mg/1 500 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:360 /30Days |
ASTRAMORPH PF INJECTION 0.5MG/ML ![Compare how all Medicare Part D PDP plans in MS cover ASTRAMORPH PF INJECTION 0.5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ATENOLOL 100mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL 100mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
Atenolol 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Atenolol 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ATENOLOL TABLET USP 50MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL TABLET USP 50MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL/CHLORTHALIDONE TABLET 100-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $12.00 | None |
ATGAM 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in MS cover ATGAM 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ATORVASTATIN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
ATORVASTATIN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATORVASTATIN 40 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
ATORVASTATIN 80 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in MS cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:26 /30Days |
AVANDIA 2mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDIA 2mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | S |
AVANDIA 4mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDIA 4mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | S |
AVANDIA 8mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDIA 8mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | S |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
AVELOX 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AVELOX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
AVODART 0.5MG SOFTGEL ![Compare how all Medicare Part D PDP plans in MS cover AVODART 0.5MG SOFTGEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:30 /30Days |
AVONEX ADMIN PACK 30MCG VL ![Compare how all Medicare Part D PDP plans in MS cover AVONEX ADMIN PACK 30MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZACTAM INJECTION 1GM/50ML ![Compare how all Medicare Part D PDP plans in MS cover AZACTAM INJECTION 1GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AZACTAM INJECTION 2GM/50ML ![Compare how all Medicare Part D PDP plans in MS cover AZACTAM INJECTION 2GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
AZATHIOPRINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZATHIOPRINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
AZATHIOPRINE SOD 100MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover AZATHIOPRINE SOD 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | P |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in MS cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | Q:30 /30Days |
AZELASTINE HYDROCHLORIDE OPHTHALMIC SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AZELASTINE HYDROCHLORIDE OPHTHALMIC SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 100MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 200MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
Azithromycin 500mg/1 10 VIAL, SINGLE-USE in 1 TRAY / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover Azithromycin 500mg/1 10 VIAL, SINGLE-USE in 1 TRAY / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$60.00 | $180.00 | None |
Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Azithromycin 600mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Azithromycin 600mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in MS cover AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AZOR 10MG-20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZOR 10MG-20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AZOR 10MG-40MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover AZOR 10MG-40MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AZOR 5MG-20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover AZOR 5MG-20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AZOR 5MG-40MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZOR 5MG-40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $120.00 | None |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |