2014 Medicare Part D Plan Formulary Information |
Transamerica MedicareRx Classic (PDP) (S9579-019-0)
Benefit Details
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The Transamerica MedicareRx Classic (PDP) (S9579-019-0) Formulary Drugs Starting with the Letter A in CMS PDP Region 20 which includes: MS Plan Monthly Premium: $46.10 Deductible: $310 Qualifies for LIS: No |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | None |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in MS cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ABELCENT INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in MS cover ABELCENT INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S Q:60 /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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S Q:90 /30Days |
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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | S Q:161 /28Days |
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 |
25% | 25% | Q:1 /28Days |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in MS cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:90 /30Days |
ACARBOSE 25 MG TABLETS ![Compare how all Medicare Part D PDP plans in MS cover ACARBOSE 25 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:90 /30Days |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:90 /30Days |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$45.00 | $115.00 | 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 |
$8.00 | $20.00 | Q:180 /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 |
$8.00 | $20.00 | Q:2500 /30Days |
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 |
$8.00 | $20.00 | Q:360 /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 |
$8.00 | $20.00 | Q:360 /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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover ACETAZOLAMIDE EXTENDED RELEASE CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | P |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in MS cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in MS cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in MS cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ACTEMRA 162 MG/0.9 ML SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ACTEMRA 162 MG/0.9 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:4 /28Days |
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 |
25% | 25% | P Q:40 /30Days |
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 |
$45.00 | $115.00 | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ACTOPLUS MET XR TABLETS EXTENDED RELEASE 15;1000 MG;MG ![Compare how all Medicare Part D PDP plans in MS cover ACTOPLUS MET XR TABLETS EXTENDED RELEASE 15;1000 MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | Q:60 /30Days |
ACTOPLUS MET XR TABLETS EXTENDED RELEASE 30;1000 MG;MG ![Compare how all Medicare Part D PDP plans in MS cover ACTOPLUS MET XR TABLETS EXTENDED RELEASE 30;1000 MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | Q:30 /30Days |
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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | P |
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 |
$45.00 | $115.00 | 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 |
25% | 25% | 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 |
25% | 25% | P Q:4 /28Days |
ADAPALENE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in MS cover ADAPALENE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ADAPALENE 0.1% GEL ![Compare how all Medicare Part D PDP plans in MS cover ADAPALENE 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Adapalene 0.3% gel ![Compare how all Medicare Part D PDP plans in MS cover Adapalene 0.3% gel.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
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 |
25% | 25% | P Q:60 /30Days |
ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera] ![Compare how all Medicare Part D PDP plans in MS cover ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:90 /30Days |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:90 /30Days |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:90 /30Days |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:90 /30Days |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:90 /30Days |
Adrenalin 1 mg/ml vial ![Compare how all Medicare Part D PDP plans in MS cover Adrenalin 1 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
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 |
$45.00 | $115.00 | 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 |
$45.00 | $115.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$45.00 | $115.00 | 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 |
$45.00 | $115.00 | Q:12 /28Days |
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 |
$45.00 | $115.00 | Q:12 /28Days |
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 |
$45.00 | $115.00 | Q:12 /28Days |
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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:28 /28Days |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:112 /28Days |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:112 /28Days |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:112 /28Days |
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 |
25% | 25% | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
25% | 25% | P Q:28 /28Days |
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 |
25% | 25% | P Q:28 /28Days |
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 |
$95.00 | $240.00 | Q:60 /30Days |
ALA-CORT 1% CREAM ![Compare how all Medicare Part D PDP plans in MS cover ALA-CORT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ALA-SCALP HP 2% LOTION ![Compare how all Medicare Part D PDP plans in MS cover ALA-SCALP HP 2% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Alagesic LQ 325; 50; 40mg/15mL; mg/15mL; mg/15mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Alagesic LQ 325; 50; 40mg/15mL; mg/15mL; mg/15mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P Q:2700 /30Days |
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) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | None |
ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per 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 per 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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | P |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
ALCAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover ALCAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ALCLOMETASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in MS cover ALCLOMETASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Alclometasone Dipropionate 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MS cover Alclometasone Dipropionate 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
25% | 25% | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Alendronate Sodium 35mg, 4 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Alendronate Sodium 35mg, 4 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALENDRONATE SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
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) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Alendronate Sodium 70 mg tab ![Compare how all Medicare Part D PDP plans in MS cover Alendronate Sodium 70 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:4 /28Days |
Alendronate Sodium 70 mg/75 ml ![Compare how all Medicare Part D PDP plans in MS cover Alendronate Sodium 70 mg/75 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:300 /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 |
$8.00 | $20.00 | None |
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 |
25% | 25% | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | None |
ALLOPURINOL 100 MG TABLETS ![Compare how all Medicare Part D PDP plans in MS cover ALLOPURINOL 100 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET per 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 per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$8.00 | $20.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Alprazolam 0.25mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam 0.25mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | Q:90 /30Days |
Alprazolam 0.5mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam 0.5mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:90 /30Days |
Alprazolam 0.5mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam 0.5mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:90 /30Days |
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 |
$8.00 | $20.00 | Q:90 /30Days |
Alprazolam 1mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam 1mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | Q:90 /30Days |
Alprazolam 2mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam 2mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:90 /30Days |
ALPRAZOLAM ER 1 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ALPRAZOLAM ER 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:60 /30Days |
Alprazolam xr 2 mg tablet ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam xr 2 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:60 /30Days |
Alprazolam xr 3 mg tablet ![Compare how all Medicare Part D PDP plans in MS cover Alprazolam xr 3 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$45.00 | $115.00 | 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 |
$8.00 | $20.00 | None |
AMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amethia 2 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MS cover Amethia 2 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:91 /84Days |
AMIFOSTINE 50mg/mL 3 VIAL, SINGLE-USE per 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 per CARTON / 10 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Aminophylline 25mg/mL 5 TRAY per 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 per 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 |
$8.00 | $20.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | P |
AMINOSYN M 3.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover AMINOSYN M 3.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$95.00 | $240.00 | 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 |
$8.00 | $20.00 | None |
AMIODARONE HCL 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
AMIODARONE HCL 50 MG INJECTION ![Compare how all Medicare Part D PDP plans in MS cover AMIODARONE HCL 50 MG INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$45.00 | $115.00 | 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 |
$45.00 | $115.00 | Q:60 /30Days |
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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | P |
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 |
$8.00 | $20.00 | P |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
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 |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 10-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 10-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 10-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 10-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amlodipine-Atorvastatin 10-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 10-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 10-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 10-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 2.5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 2.5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 2.5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 2.5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 2.5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 2.5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 5-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in MS cover Amlodipine-Atorvastatin 5-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 10-40 MG ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE-BENAZEPRIL 10-40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-40 MG ![Compare how all Medicare Part D PDP plans in MS cover AMLODIPINE-BENAZEPRIL 5-40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMMONIUM CHLORIDE 5 MEQ/ML ![Compare how all Medicare Part D PDP plans in MS cover AMMONIUM CHLORIDE 5 MEQ/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in MS cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | None |
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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Amoxicillin 500mg/1 500 CAPSULE BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MS cover Amoxicillin 500mg/1 500 CAPSULE BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$8.00 | $20.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS EXTENDED RELEASE 1000;62.5MG;MG ![Compare how all Medicare Part D PDP plans in MS cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS EXTENDED RELEASE 1000;62.5MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$8.00 | $20.00 | 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 |
$0.00 | $0.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$8.00 | $20.00 | Q:60 /30Days |
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 |
$8.00 | $20.00 | Q:60 /30Days |
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 |
$8.00 | $20.00 | Q:60 /30Days |
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 |
$8.00 | $20.00 | Q:60 /30Days |
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 |
$8.00 | $20.00 | Q:60 /30Days |
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 |
$8.00 | $20.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$8.00 | $20.00 | P |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in MS cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
AMPICILLIN FOR INJECTION POWDER ![Compare how all Medicare Part D PDP plans in MS cover AMPICILLIN FOR INJECTION POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$8.00 | $20.00 | None |
ampicillin-sulbactam 15 gm vl ![Compare how all Medicare Part D PDP plans in MS cover ampicillin-sulbactam 15 gm vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ampicillin-sulbactam 3 gm vial ![Compare how all Medicare Part D PDP plans in MS cover ampicillin-sulbactam 3 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
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 |
25% | 25% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | P |
ANDRODERM 2 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in MS cover ANDRODERM 2 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | P Q:30 /30Days |
ANDRODERM 4 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in MS cover ANDRODERM 4 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | P Q:30 /30Days |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in MS cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | Q:60 /30Days |
Apexicon E 0.05% Cream ![Compare how all Medicare Part D PDP plans in MS cover Apexicon E 0.05% Cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | None |
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 |
25% | 25% | Q:60 /30Days |
Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER per 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 per CARTON / 10 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
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 |
$45.00 | $115.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | S |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | S |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | S |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | S |
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 |
25% | 25% | 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) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | None |
Aralast NP 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MS cover Aralast NP 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | 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 |
$8.00 | $20.00 | 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 |
25% | 25% | None |
ARRANON 250MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARRANON 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ARZERRA 20mg/mL 3 VIAL per CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover ARZERRA 20mg/mL 3 VIAL per CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:80 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ascomp with Codeine 325; 50; 40; 30mg/1; mg/1; mg/1; mg/1 500 CAPSULE 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 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P Q:180 /30Days |
ASTAGRAF XL 0.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ASTAGRAF XL 0.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P |
ASTAGRAF XL 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ASTAGRAF XL 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P |
ASTAGRAF XL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover ASTAGRAF XL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P |
ASTEPRO 0.15% NASAL SPRAY 30 ML ![Compare how all Medicare Part D PDP plans in MS cover ASTEPRO 0.15% NASAL SPRAY 30 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | Q:30 /25Days |
ATENOLOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in MS cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | 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 |
$0.00 | $0.00 | None |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in MS cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in MS cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Atovaquone and Proguanil Hydrochloride 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in MS cover Atovaquone and Proguanil Hydrochloride 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
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 |
25% | 25% | None |
ATROPINE 0.05MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ATROPINE 0.05MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
ATROPINE 0.1MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover ATROPINE 0.1MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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) |
3 |
Preferred Brand |
$45.00 | $115.00 | Q:26 /28Days |
AUBAGIO 14 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AUBAGIO 14 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:28 /28Days |
AUBAGIO 7 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AUBAGIO 7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AUGMENTED BETAMETHASONE DIPROPIONATE OINTMENT ![Compare how all Medicare Part D PDP plans in MS cover AUGMENTED BETAMETHASONE DIPROPIONATE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
AVANDAMET 1000; 2mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDAMET 1000; 2mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:60 /30Days |
AVANDAMET 1000; 4mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDAMET 1000; 4mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:60 /30Days |
AVANDAMET 500; 2mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDAMET 500; 2mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:60 /30Days |
AVANDAMET 500; 4mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDAMET 500; 4mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:60 /30Days |
AVANDARYL 1; 4mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDARYL 1; 4mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:30 /30Days |
AVANDARYL 2; 4mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDARYL 2; 4mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:30 /30Days |
AVANDARYL 2; 8mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDARYL 2; 8mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:30 /30Days |
AVANDARYL 4; 4mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDARYL 4; 4mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:30 /30Days |
AVANDARYL 4; 8mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover AVANDARYL 4; 8mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | P Q:30 /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 |
$95.00 | $240.00 | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$95.00 | $240.00 | P Q:30 /30Days |
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 |
$95.00 | $240.00 | P Q:30 /30Days |
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 |
25% | 25% | P |
AVELOX ABC PACK 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AVELOX ABC PACK 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | None |
AVELOX IV 400MG/250ML ![Compare how all Medicare Part D PDP plans in MS cover AVELOX IV 400MG/250ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $240.00 | None |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in MS cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
AVITA 0.025% CREAM ![Compare how all Medicare Part D PDP plans in MS cover AVITA 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
Avita 0.25mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MS cover Avita 0.25mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | P |
Azacitidine 100 mg vial [Vidaza] ![Compare how all Medicare Part D PDP plans in MS cover Azacitidine 100 mg vial [Vidaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | 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 |
$8.00 | $20.00 | P |
AZELASTINE 0.15% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in MS cover AZELASTINE 0.15% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:30 /25Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | Q:30 /25Days |
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 |
$8.00 | $20.00 | None |
AZILECT 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZILECT 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | None |
AZILECT 1MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover AZILECT 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $115.00 | None |
AZITHROMYCIN 1 GM PWD PACKET ![Compare how all Medicare Part D PDP plans in MS cover AZITHROMYCIN 1 GM PWD PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Azithromycin 100mg/5mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Azithromycin 100mg/5mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
Azithromycin 200mg/5mL 22.5 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MS cover Azithromycin 200mg/5mL 22.5 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | None |
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 |
$8.00 | $20.00 | None |
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) |
2 |
Non-Preferred Generic |
$8.00 | $20.00 | 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 |
$8.00 | $20.00 | None |
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 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
$45.00 | $115.00 | 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 |
$8.00 | $20.00 | None |