2013 Medicare Part D Plan Formulary Information |
WPS MedicareRx Plan 1 (PDP) (S5753-006-0)
Benefit Details
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The WPS MedicareRx Plan 1 (PDP) (S5753-006-0) Formulary Drugs Starting with the Letter N in CMS PDP Region 16 which includes: WI
|
Drugs Starting with Letter N
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
NABUMETONE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NABUMETONE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NABUMETONE 750MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NABUMETONE 750MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NADOLOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NADOLOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NADOLOL TABLETS ![Compare how all Medicare Part D PDP plans in WI cover NADOLOL TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NADOLOL TABLETS ![Compare how all Medicare Part D PDP plans in WI cover NADOLOL TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NADOLOL-BENDROFLU 40-5 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover NADOLOL-BENDROFLU 40-5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NADOLOL-BENDROFLU 80-5 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover NADOLOL-BENDROFLU 80-5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nafcillin 10g/100mL ![Compare how all Medicare Part D PDP plans in WI cover Nafcillin 10g/100mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NAFCILLIN 1GM/50ML INJ ![Compare how all Medicare Part D PDP plans in WI cover NAFCILLIN 1GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NAFCILLIN FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in WI cover NAFCILLIN FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NAFTIN 1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover NAFTIN 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NAFTIN HCL GEL 1% 60GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover NAFTIN HCL GEL 1% 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NAGLAZYME 5MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover NAGLAZYME 5MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
naloxone 1 mg/ml syringe ![Compare how all Medicare Part D PDP plans in WI cover naloxone 1 mg/ml syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NALTREXONE HCL 50MG TABLET 100 BLPK ![Compare how all Medicare Part D PDP plans in WI cover NALTREXONE HCL 50MG TABLET 100 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NAMENDA 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NAMENDA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NAMENDA 10MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover NAMENDA 10MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NAMENDA 5-10MG TITRATION PK ![Compare how all Medicare Part D PDP plans in WI cover NAMENDA 5-10MG TITRATION PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NAMENDA 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NAMENDA 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:270 /90Days |
NAPROXEN 125MG/5ML SUSPEN ![Compare how all Medicare Part D PDP plans in WI cover NAPROXEN 125MG/5ML SUSPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NAPROXEN 250 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in WI cover NAPROXEN 250 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NAPROXEN 375MG TABLET EC ![Compare how all Medicare Part D PDP plans in WI cover NAPROXEN 375MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NAPROXEN 500MG TABLET EC ![Compare how all Medicare Part D PDP plans in WI cover NAPROXEN 500MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Naproxen 500mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Naproxen 500mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NAPROXEN SODIUM 275 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in WI cover NAPROXEN SODIUM 275 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Naproxen Sodium 550mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Naproxen Sodium 550mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NAPROXEN TABLET 375MG (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover NAPROXEN TABLET 375MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NARATRIPTAN TABLETS ![Compare how all Medicare Part D PDP plans in WI cover NARATRIPTAN TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:36 /90Days |
NARATRIPTAN TABLETS ![Compare how all Medicare Part D PDP plans in WI cover NARATRIPTAN TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:24 /90Days |
NASONEX 50ug/1 120 SPRAY, METERED in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in WI cover NASONEX 50ug/1 120 SPRAY, METERED in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NATACYN EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover NATACYN EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
Nateglinide 120mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nateglinide 120mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:270 /90Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Nateglinide 60mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nateglinide 60mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:270 /90Days |
NEBUPENT 300MG INHAL POWDER ![Compare how all Medicare Part D PDP plans in WI cover NEBUPENT 300MG INHAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | P |
NECON 0.5/35-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover NECON 0.5/35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NECON 1/35-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover NECON 1/35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NECON 10/11-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover NECON 10/11-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NECON 7 DAYS X 3 TABLET ![Compare how all Medicare Part D PDP plans in WI cover NECON 7 DAYS X 3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NEFAZODONE HCL 150MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in WI cover NEFAZODONE HCL 150MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:180 /90Days |
NEFAZODONE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NEFAZODONE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:180 /90Days |
NEFAZODONE HCL 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NEFAZODONE HCL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:180 /90Days |
NEFAZODONE HYDROCHLORIDE TABLETS 100MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover NEFAZODONE HYDROCHLORIDE TABLETS 100MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:180 /90Days |
NEFAZODONE HYDROCHLORIDE TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover NEFAZODONE HYDROCHLORIDE TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:180 /90Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NEO/POLYMYXIN/HC EAR TUBEX 10MG/3.5MG/100UNT ![Compare how all Medicare Part D PDP plans in WI cover NEO/POLYMYXIN/HC EAR TUBEX 10MG/3.5MG/100UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Neomycin and Polymyxin B Sulfates and Dexamethasone 1; 3.5; 10000mg/g; mg/g; [USP'U]/g 1 TUBE in 1 ![Compare how all Medicare Part D PDP plans in WI cover Neomycin and Polymyxin B Sulfates and Dexamethasone 1; 3.5; 10000mg/g; mg/g; [USP'U]/g 1 TUBE in 1 .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NEOMYCIN SULFATE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NEOMYCIN SULFATE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NEOMYCIN-BACITRACIN-POLY-HC 3.5-10K-1 OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover NEOMYCIN-BACITRACIN-POLY-HC 3.5-10K-1 OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NEOMYCIN-POLYMYXIN-HC 3.5-10K-10 SUSPENSION DROPS ![Compare how all Medicare Part D PDP plans in WI cover NEOMYCIN-POLYMYXIN-HC 3.5-10K-10 SUSPENSION DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NEOMYCIN/POLYMY/DEXA EYE DROPS 3.5MG/1ML ![Compare how all Medicare Part D PDP plans in WI cover NEOMYCIN/POLYMY/DEXA EYE DROPS 3.5MG/1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M ![Compare how all Medicare Part D PDP plans in WI cover NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NEOMYCIN/POLYMY/HYDRO OTIC SUS ![Compare how all Medicare Part D PDP plans in WI cover NEOMYCIN/POLYMY/HYDRO OTIC SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NEORAL 100MG GELATN CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover NEORAL 100MG GELATN CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | P |
NEORAL 100MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover NEORAL 100MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | P |
NEORAL 25MG GELATIN CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover NEORAL 25MG GELATIN CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NEPHRAMINE SOLUTION FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover NEPHRAMINE SOLUTION FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NEULASTA 6MG/0.6ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover NEULASTA 6MG/0.6ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | P Q:4 /90Days |
NEUPOGEN 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover NEUPOGEN 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:67 /90Days |
NEUPOGEN 300ug/0.5mL 10 SYRINGE in 1 BOX / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover NEUPOGEN 300ug/0.5mL 10 SYRINGE in 1 BOX / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:21 /90Days |
NEUPOGEN INJECTION 480MCG/0.8ML 10 X 0.8ML SYR ![Compare how all Medicare Part D PDP plans in WI cover NEUPOGEN INJECTION 480MCG/0.8ML 10 X 0.8ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:34 /90Days |
NEVANAC 0.1% DROPTAINER ![Compare how all Medicare Part D PDP plans in WI cover NEVANAC 0.1% DROPTAINER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
nevirapine 200 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover nevirapine 200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | Q:180 /90Days |
NEXAVAR TABLETS 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in WI cover NEXAVAR TABLETS 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:360 /90Days |
NEXIUM IV 20MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover NEXIUM IV 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NEXIUM IV 40MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover NEXIUM IV 40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NEXT CHOICE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NEXT CHOICE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NIASPAN 1000MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WI cover NIASPAN 1000MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NIASPAN ER 500MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WI cover NIASPAN ER 500MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NIASPAN ER 750MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in WI cover NIASPAN ER 750MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NICARDIPINE HYDROCHLORIDE CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover NICARDIPINE HYDROCHLORIDE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NICARDIPINE HYDROCHLORIDE CAPSULES 30MG 500 BOT ![Compare how all Medicare Part D PDP plans in WI cover NICARDIPINE HYDROCHLORIDE CAPSULES 30MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NICOTROL INHALER 10MG 168 X 10MG/CARTRIDGE INHL ![Compare how all Medicare Part D PDP plans in WI cover NICOTROL INHALER 10MG 168 X 10MG/CARTRIDGE INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | P Q:1008 /90Days |
NICOTROL NS NASAL SPRAY BOTTLE 10MG 4 X 10MG/ML INHL ![Compare how all Medicare Part D PDP plans in WI cover NICOTROL NS NASAL SPRAY BOTTLE 10MG 4 X 10MG/ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | P Q:120 /90Days |
NIFEDIAC CC 90MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover NIFEDIAC CC 90MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIFEDICAL XL 30MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in WI cover NIFEDICAL XL 30MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIFEDICAL XL 60MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in WI cover NIFEDICAL XL 60MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nifedipine 10mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nifedipine 10mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NIFEDIPINE 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover NIFEDIPINE 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIFEDIPINE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover NIFEDIPINE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIFEDIPINE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover NIFEDIPINE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIFEDIPINE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover NIFEDIPINE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NILANDRON 150MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NILANDRON 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | Q:120 /90Days |
Nimodipine 30mg/1 10 BLISTER PACK in 1 CARTON / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Nimodipine 30mg/1 10 BLISTER PACK in 1 CARTON / 10 CAPSULE, LIQUID FILLED in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIPENT FOR INJECTION 10MG VIALS ![Compare how all Medicare Part D PDP plans in WI cover NIPENT FOR INJECTION 10MG VIALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | None |
Nisoldipine 17mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Nisoldipine 17mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NISOLDIPINE 20MG TB24 ![Compare how all Medicare Part D PDP plans in WI cover NISOLDIPINE 20MG TB24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nisoldipine 25.5mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Nisoldipine 25.5mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NISOLDIPINE 30MG TB24 ![Compare how all Medicare Part D PDP plans in WI cover NISOLDIPINE 30MG TB24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Nisoldipine 34mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Nisoldipine 34mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NISOLDIPINE 40MG TB24 ![Compare how all Medicare Part D PDP plans in WI cover NISOLDIPINE 40MG TB24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nisoldipine 8.5mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Nisoldipine 8.5mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NITRO-BID 20mg/g 48 PACKET in 1 BOX / 1 g in 1 PACKET ![Compare how all Medicare Part D PDP plans in WI cover NITRO-BID 20mg/g 48 PACKET in 1 BOX / 1 g in 1 PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NITRO-DUR 0.3 MG/HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover NITRO-DUR 0.3 MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NITRO-DUR 0.8 MG/HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover NITRO-DUR 0.8 MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
Nitrofurantoin 25mg/5mL ![Compare how all Medicare Part D PDP plans in WI cover Nitrofurantoin 25mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NITROFURANTOIN MCR 50MG CAP ![Compare how all Medicare Part D PDP plans in WI cover NITROFURANTOIN MCR 50MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nitrofurantoin Monohydrate/Macrocrystals 25; 75mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nitrofurantoin Monohydrate/Macrocrystals 25; 75mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NITROGLYCERIN .2MG/HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover NITROGLYCERIN .2MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NITROGLYCERIN .4MG/HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover NITROGLYCERIN .4MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NITROGLYCERIN .6MG/HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover NITROGLYCERIN .6MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nitroglycerin 5mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 10 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Nitroglycerin 5mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 10 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | P |
NITROGLYCERIN TRANSOERMAL SYSTEM .1MG/HR 30 SYSTEM BOX ![Compare how all Medicare Part D PDP plans in WI cover NITROGLYCERIN TRANSOERMAL SYSTEM .1MG/HR 30 SYSTEM BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nitrolingual Pumpspray 400ug/1 200 SPRAY, METERED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nitrolingual Pumpspray 400ug/1 200 SPRAY, METERED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NITROSTAT 0.3MG TABLET SL ![Compare how all Medicare Part D PDP plans in WI cover NITROSTAT 0.3MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NITROSTAT 0.4MG TABLET SL ![Compare how all Medicare Part D PDP plans in WI cover NITROSTAT 0.4MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NITROSTAT 0.6MG TABLET SL ![Compare how all Medicare Part D PDP plans in WI cover NITROSTAT 0.6MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
Nizatidine 150mg/1 500 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nizatidine 150mg/1 500 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIZATIDINE 300 MG CAPSULE (100 CAPS) ![Compare how all Medicare Part D PDP plans in WI cover NIZATIDINE 300 MG CAPSULE (100 CAPS).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NIZATIDINE ORAL SOLUTION 15MG/ML ![Compare how all Medicare Part D PDP plans in WI cover NIZATIDINE ORAL SOLUTION 15MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NORA-BE 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NORA-BE 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Norditropin 10mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Norditropin 10mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
Norditropin 15mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Norditropin 15mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
Norditropin 5mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Norditropin 5mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
NORDITROPIN NORDIFLEX INJECTION ![Compare how all Medicare Part D PDP plans in WI cover NORDITROPIN NORDIFLEX INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
NORETHINDRONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NORETHINDRONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NORMOSOL -R INJ /D5W ![Compare how all Medicare Part D PDP plans in WI cover NORMOSOL -R INJ /D5W.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NORMOSOL-R PH 7.4 IV SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover NORMOSOL-R PH 7.4 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NOROXIN 400mg/1 20 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover NOROXIN 400mg/1 20 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | None |
NORPACE CR 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover NORPACE CR 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
NORPACE CR 150MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover NORPACE CR 150MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
Nortrel (21 Day Regimen) 0.035; 1mg/1; mg/1 3 BLISTER PACK in 1 CARTON / 21 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Nortrel (21 Day Regimen) 0.035; 1mg/1; mg/1 3 BLISTER PACK in 1 CARTON / 21 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Nortrel (28 Day Regimen) 3 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Nortrel (28 Day Regimen) 3 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NORTREL 1-0.035MG TABLET 28DAY ![Compare how all Medicare Part D PDP plans in WI cover NORTREL 1-0.035MG TABLET 28DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
Nortrel 7/7/7 (28 Day Regimen) 6 POUCH in 1 CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER ![Compare how all Medicare Part D PDP plans in WI cover Nortrel 7/7/7 (28 Day Regimen) 6 POUCH in 1 CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$13.00 | $32.50 | None |
NORTRIPTYLINE HCL 25MG CAP ![Compare how all Medicare Part D PDP plans in WI cover NORTRIPTYLINE HCL 25MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NORTRIPTYLINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover NORTRIPTYLINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Nortriptyline Hydrochloride 10mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nortriptyline Hydrochloride 10mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Nortriptyline Hydrochloride 50mg/1 500 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Nortriptyline Hydrochloride 50mg/1 500 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NORVIR 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover NORVIR 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:1080 /90Days |
NORVIR 100mg/1 30 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover NORVIR 100mg/1 30 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:1080 /90Days |
NORVIR 80MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover NORVIR 80MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:1440 /90Days |
NOXAFIL 200MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in WI cover NOXAFIL 200MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NUCYNTA 100mg/1 10 BLISTER PACK in 1 BOX, UNIT-DOSE / 10 FILM COATED TABLETS in BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA 100mg/1 10 BLISTER PACK in 1 BOX, UNIT-DOSE / 10 FILM COATED TABLETS in BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:541 /90Days |
NUCYNTA 50mg/1 10 BLISTER PACK in 1 BOX, UNIT-DOSE / 10 FILM COATED TABLETS in BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA 50mg/1 10 BLISTER PACK in 1 BOX, UNIT-DOSE / 10 FILM COATED TABLETS in BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:541 /90Days |
NUCYNTA 75mg/1 10 BLISTER PACK in 1 BOX, UNIT-DOSE / 10 FILM COATED TABLETS in BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA 75mg/1 10 BLISTER PACK in 1 BOX, UNIT-DOSE / 10 FILM COATED TABLETS in BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:541 /90Days |
NUCYNTA ER 100mg/1 60 TABLET, FILM COATED ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA ER 100mg/1 60 TABLET, FILM COATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NUCYNTA ER 150mg/1 60 TABLET, FILM COATED ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA ER 150mg/1 60 TABLET, FILM COATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NUCYNTA ER 200mg/1 60 TABLET, FILM COATED ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA ER 200mg/1 60 TABLET, FILM COATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NUCYNTA ER 250mg/1 60 TABLET, FILM COATED ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA ER 250mg/1 60 TABLET, FILM COATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NUCYNTA ER 50mg/1 60 TABLET, FILM COATED ![Compare how all Medicare Part D PDP plans in WI cover NUCYNTA ER 50mg/1 60 TABLET, FILM COATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NUEDEXTA 20; 10mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in WI cover NUEDEXTA 20; 10mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$39.00 | $97.50 | Q:180 /90Days |
NULOJIX 250mg/1 1 VIAL, SINGLE-USE in 1 CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in ![Compare how all Medicare Part D PDP plans in WI cover NULOJIX 250mg/1 1 VIAL, SINGLE-USE in 1 CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
NUVARING 0.12-0.015 RING VAGINAL ![Compare how all Medicare Part D PDP plans in WI cover NUVARING 0.12-0.015 RING VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NYAMYC 100000 U/G POWDER ![Compare how all Medicare Part D PDP plans in WI cover NYAMYC 100000 U/G POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Nystatin 100000[USP'U]/g ![Compare how all Medicare Part D PDP plans in WI cover Nystatin 100000[USP'U]/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Nystatin 100000[USP'U]/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Nystatin 100000[USP'U]/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Nystatin 100000[USP'U]/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Nystatin 100000[USP'U]/g 1 TUBE in 1 CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
Nystatin 100000[USP'U]/mL ![Compare how all Medicare Part D PDP plans in WI cover Nystatin 100000[USP'U]/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NYSTATIN TABLET 500000U (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover NYSTATIN TABLET 500000U (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NYSTATIN/TRIAMCINOLONE CRM ![Compare how all Medicare Part D PDP plans in WI cover NYSTATIN/TRIAMCINOLONE CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NYSTATIN/TRIAMCINOLONE OINT 10000UNT/1MG ![Compare how all Medicare Part D PDP plans in WI cover NYSTATIN/TRIAMCINOLONE OINT 10000UNT/1MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |
NYSTOP 100000U/GM POWDER ![Compare how all Medicare Part D PDP plans in WI cover NYSTOP 100000U/GM POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $15.00 | None |