2014 Medicare Part D Plan Formulary Information |
Kaiser Permanente Medicare Plus Std w/Part D (B) (Cost) (H2150-029-0)
Benefit Details
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The Kaiser Permanente Medicare Plus Std w/Part D (B) (Cost) (H2150-029-0) Formulary Drugs Starting with the Letter R in PRINCE WILLIAM County, VA: CMS MA Region 7 which includes: VA Plan Monthly Premium: $36.00 Deductible: $0 |
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Rabeprazole Sodium DR 20 MG Tablet [AcipHex] ![Compare how all Medicare Part D PDP plans in VA cover Rabeprazole Sodium DR 20 MG Tablet [AcipHex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL ![Compare how all Medicare Part D PDP plans in VA cover RABIES VACCINE RABAVERT INJECTION 2.5UNT/ML 1 DOSE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Vaccines |
$0.00 | N/A | None |
RAGWITEK SUBLINGUAL TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAGWITEK SUBLINGUAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Raloxifene HCl 60 mg tablet [Evista] ![Compare how all Medicare Part D PDP plans in VA cover Raloxifene HCl 60 mg tablet [Evista].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RANEXA ER 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RANEXA ER 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RANEXA ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RANEXA ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Ranitidine 16.8mg/mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine 16.8mg/mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RANITIDINE HCL 150 MG/6 ML VL ![Compare how all Medicare Part D PDP plans in VA cover RANITIDINE HCL 150 MG/6 ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RANITIDINE TABLET USP 150MG (500 CT) ![Compare how all Medicare Part D PDP plans in VA cover RANITIDINE TABLET USP 150MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RAPAFLO CAPSULES 4MG 30 BOT ![Compare how all Medicare Part D PDP plans in VA cover RAPAFLO CAPSULES 4MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAPAFLO CAPSULES 8MG 90 BOT ![Compare how all Medicare Part D PDP plans in VA cover RAPAFLO CAPSULES 8MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAPAMUNE 0.5MG TABLETS ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 0.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RAPAMUNE 1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RAPAMUNE 2MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
RAVICTI 1.1 GRAM/ML LIQUID ![Compare how all Medicare Part D PDP plans in VA cover RAVICTI 1.1 GRAM/ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
RAYOS DR 1 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAYOS DR 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
RAYOS DR 2 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAYOS DR 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
RAYOS DR 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAYOS DR 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
RAZADYNE 12MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE 12MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAZADYNE 4MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAZADYNE 8MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAZADYNE ER 16MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE ER 16MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAZADYNE ER 24MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE ER 24MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RAZADYNE ER 8MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE ER 8MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RAZADYNE SOL 4MG/ML ![Compare how all Medicare Part D PDP plans in VA cover RAZADYNE SOL 4MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REBETOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REBETOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REBETOL 40MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover REBETOL 40MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in VA cover REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in VA cover REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in VA cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
RECLAST 5MG/100ML INJECTION ![Compare how all Medicare Part D PDP plans in VA cover RECLAST 5MG/100ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in VA cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Vaccines |
$0.00 | N/A | P |
RECTIV 0.4% OINTMENT ![Compare how all Medicare Part D PDP plans in VA cover RECTIV 0.4% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in VA cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in VA cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RELISTOR 12 MG/0.6 ML KIT ![Compare how all Medicare Part D PDP plans in VA cover RELISTOR 12 MG/0.6 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RELPAX 20MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RELPAX 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RELPAX 40MG TABLET 6X2 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RELPAX 40MG TABLET 6X2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMERON 15MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REMERON 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMERON 30MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REMERON 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMERON 45MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REMERON 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMERON SLTABLET 15MG TABLET 30 BLPK CRTN ![Compare how all Medicare Part D PDP plans in VA cover REMERON SLTABLET 15MG TABLET 30 BLPK CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMERON SLTABLET 30MG TABLET 30 TABLET S CRTN ![Compare how all Medicare Part D PDP plans in VA cover REMERON SLTABLET 30MG TABLET 30 TABLET S CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMERON SLTABLET 45MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REMERON SLTABLET 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMICADE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REMODULIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REMODULIN 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REMODULIN 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REMODULIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
RENAGEL 400MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RENAGEL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RENAGEL 800MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RENAGEL 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
Repaglinide 0.5 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in VA cover Repaglinide 0.5 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Repaglinide 1 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in VA cover Repaglinide 1 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Repaglinide 2 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in VA cover Repaglinide 2 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Reprexain 10-200 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Reprexain 10-200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Reprexain 2.5-200 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Reprexain 2.5-200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Reprexain 5-200 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Reprexain 5-200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
REQUIP 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP 1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP 2MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP 3MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP 4MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP 5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REQUIP 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP XL 2mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover REQUIP XL 2mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP XL 4mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover REQUIP XL 4mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REQUIP XL 6mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover REQUIP XL 6mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP XL 8mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover REQUIP XL 8mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
REQUIP XL TABLET 12 MG ![Compare how all Medicare Part D PDP plans in VA cover REQUIP XL TABLET 12 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RESCRIPTOR 100mg/1 360 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RESCRIPTOR 100mg/1 360 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RESCRIPTOR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RESCRIPTOR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RESCULA 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover RESCULA 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RESERPINE 0.1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RESERPINE 0.1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
Reserpine 0.25mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Reserpine 0.25mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in VA cover RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RESTORIL 15mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RESTORIL 15mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RESTORIL 22.5mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RESTORIL 22.5mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RESTORIL 30mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RESTORIL 30mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RESTORIL 7.5mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RESTORIL 7.5mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RETIN A CREAM ![Compare how all Medicare Part D PDP plans in VA cover RETIN A CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETIN-A 0.01% GEL ![Compare how all Medicare Part D PDP plans in VA cover RETIN-A 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETIN-A 0.025% CREAM ![Compare how all Medicare Part D PDP plans in VA cover RETIN-A 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETIN-A 0.025% GEL ![Compare how all Medicare Part D PDP plans in VA cover RETIN-A 0.025% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETIN-A 0.05% CREAM ![Compare how all Medicare Part D PDP plans in VA cover RETIN-A 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETIN-A MICRO 0.04% GEL ![Compare how all Medicare Part D PDP plans in VA cover RETIN-A MICRO 0.04% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETIN-A MICRO 0.1% GEL ![Compare how all Medicare Part D PDP plans in VA cover RETIN-A MICRO 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
RETROVIR 100mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RETROVIR 100mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RETROVIR 10mg/mL 10 VIAL, SINGLE-USE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in VA cover RETROVIR 10mg/mL 10 VIAL, SINGLE-USE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RETROVIR 50mg/5mL 240 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RETROVIR 50mg/5mL 240 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Revatio 0.8mg/mL 12.5 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in VA cover Revatio 0.8mg/mL 12.5 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVATIO 20MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REVATIO 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVIA 50MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REVIA 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
REVLIMID 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVLIMID 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVLIMID 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVLIMID 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REVLIMID 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REYATAZ 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
RHEUMATREX 2.5MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VA cover RHEUMATREX 2.5MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
RHINOCORT AQUA NASAL SPRAY 32 MCG/SPRAY ![Compare how all Medicare Part D PDP plans in VA cover RHINOCORT AQUA NASAL SPRAY 32 MCG/SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBASPHERE 400MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBASPHERE 600MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBASPHERE CAPSULES 200MG 42 BOT ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE CAPSULES 200MG 42 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBASPHERE RibaPak ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE RibaPak .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBASPHERE RibaPak 400mg/1 ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE RibaPak 400mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIBASPHERE RibaPak 600mg/1 ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE RibaPak 600mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBAVIRIN 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIBAVIRIN 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in VA cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIDAURA 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIDAURA 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RIFABUTIN 150 MG CAPSULE [Mycobutin] ![Compare how all Medicare Part D PDP plans in VA cover RIFABUTIN 150 MG CAPSULE [Mycobutin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIFADIN 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIFADIN 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIFADIN 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIFADIN 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RIFADIN IV 600MG VIAL ![Compare how all Medicare Part D PDP plans in VA cover RIFADIN IV 600MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RIFAMATE 150/300 CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIFAMATE 150/300 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in VA cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIFAMPIN 600MG VIAL ![Compare how all Medicare Part D PDP plans in VA cover RIFAMPIN 600MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIFATER 50/300/120 TABLET ![Compare how all Medicare Part D PDP plans in VA cover RIFATER 50/300/120 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RILUTEK 50 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RILUTEK 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
riluzole 50 mg tablet [Rilutek] ![Compare how all Medicare Part D PDP plans in VA cover riluzole 50 mg tablet [Rilutek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Rimantadine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Rimantadine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RINGERS 33/30/860 INJECTION ![Compare how all Medicare Part D PDP plans in VA cover RINGERS 33/30/860 INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in VA cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VA cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 1MG M-TAB ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 1MG M-TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERDAL 1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 2MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 3MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL 4MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL M TABLET 0.5MG ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL M TABLET 0.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL M-TAB 2mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL M-TAB 2mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERDAL M-TAB 3mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL M-TAB 3mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERDAL M-TAB 4mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL M-TAB 4mg/1 7 BLISTER PACK in 1 BOX / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RISPERIDONE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Risperidone 1mg/1 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VA cover Risperidone 1mg/1 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Risperidone 1mg/mL 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Risperidone 1mg/mL 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE 2 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE 3 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 0.5MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLETS ORALLY DISINTEGRATING 2MG 30 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RITALIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RITALIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITALIN 20MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RITALIN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITALIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RITALIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITALIN LA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RITALIN LA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITALIN LA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RITALIN LA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITALIN LA 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RITALIN LA 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITALIN LA 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RITALIN LA 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RITALIN-SR 20MG TABLET SA ![Compare how all Medicare Part D PDP plans in VA cover RITALIN-SR 20MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover RITUXAN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | None |
RIVASTIGMINE TARTRATE 3MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE 3MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIVASTIGMINE TARTRATE 4.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE 4.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIVASTIGMINE TARTRATE 6MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE 6MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
RIVASTIGMINE TARTRATE1.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE1.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
rizatriptan 10 mg odt ![Compare how all Medicare Part D PDP plans in VA cover rizatriptan 10 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
rizatriptan 10 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover rizatriptan 10 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
rizatriptan 5 mg odt ![Compare how all Medicare Part D PDP plans in VA cover rizatriptan 5 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
rizatriptan 5 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover rizatriptan 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROBINUL 1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROBINUL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROBINUL FORTE 2MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROBINUL FORTE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Rocaltrol 0.25ug GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Rocaltrol 0.25ug GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
Rocaltrol 0.5ug GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Rocaltrol 0.5ug GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $80.00 | P |
Rocaltrol 1ug/mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Rocaltrol 1ug/mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
ROCEPHIN 500MG/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in VA cover ROCEPHIN 500MG/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE HCL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HYDROCLORIDE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HYDROCLORIDE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE TAB 12MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 12MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE TAB 2MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 2MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE TAB 4MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 4MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE TAB 6MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 6MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROPINIROLE TAB 8MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 8MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in VA cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Vaccines |
$0.00 | N/A | None |
ROXICET 5-325/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VA cover ROXICET 5-325/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ROXICODONE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROXICODONE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ROXICODONE 30 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROXICODONE 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ROXICODONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROXICODONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROZEREM 8MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover ROZEREM 8MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RYTHMOL 150MG TABLETS ![Compare how all Medicare Part D PDP plans in VA cover RYTHMOL 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RYTHMOL FILM COATED TABLETS 225 MG ![Compare how all Medicare Part D PDP plans in VA cover RYTHMOL FILM COATED TABLETS 225 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RYTHMOL SR 225mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RYTHMOL SR 225mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RYTHMOL SR 325mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RYTHMOL SR 325mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
RYTHMOL SR 425mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RYTHMOL SR 425mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |