2014 Medicare Part D Plan Formulary Information |
Freedom Blue PPO HD Rx (PPO) (H3916-025-0)
Benefit Details
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The Freedom Blue PPO HD Rx (PPO) (H3916-025-0) Formulary Drugs Starting with the Letter Z in UNION County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $0.00 Deductible: $0 |
Drugs Starting with Letter Z
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ZAFIRLUKAST 10MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover ZAFIRLUKAST 10MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZAFIRLUKAST 20MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover ZAFIRLUKAST 20MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZALEPLON 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZALEPLON 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZALEPLON 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZALEPLON 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZALTRAP 100 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZALTRAP 100 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZAMICET SOLN 325MG; 10MG/15ML ![Compare how all Medicare Part D PDP plans in PA cover ZAMICET SOLN 325MG; 10MG/15ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | Q:5723 /31Days |
ZANOSAR 1GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZANOSAR 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZANTAC 150MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZANTAC 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZANTAC 15MG/ML SYRUP ![Compare how all Medicare Part D PDP plans in PA cover ZANTAC 15MG/ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZANTAC 25 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZANTAC 25 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZANTAC 300MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZANTAC 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZARONTIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZARONTIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZARONTIN 250MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in PA cover ZARONTIN 250MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZAVESCA 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZAVESCA 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in PA cover ZAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZAZOLE 0.8% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in PA cover ZAZOLE 0.8% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZELAPAR 1.25MG ODT TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZELAPAR 1.25MG ODT TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZELBORAF 240mg/1 1 BOTTLE, PLASTIC per CARTON / 120 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover ZELBORAF 240mg/1 1 BOTTLE, PLASTIC per CARTON / 120 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZEMAIRA 1000MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZEMAIRA 1000MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZEMPLAR 1 MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZEMPLAR 1 MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ZEMPLAR 2 MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZEMPLAR 2 MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Zemplar 2ug/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in PA cover Zemplar 2ug/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ZEMPLAR 4 MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZEMPLAR 4 MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
Zemplar 5ug/mL 25 VIAL, MULTI-DOSE in 1 TRAY / 2 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in PA cover Zemplar 5ug/mL 25 VIAL, MULTI-DOSE in 1 TRAY / 2 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ZENCHENT FE TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in PA cover ZENCHENT FE TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZENPEP 109000; 20000; 68000 DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZENPEP 109000; 20000; 68000 DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZENPEP 27000; 5000; 17000 DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZENPEP 27000; 5000; 17000 DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZENPEP 55000; 10000; 34000 DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZENPEP 55000; 10000; 34000 DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZENPEP 82000; 15000; 51000 DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZENPEP 82000; 15000; 51000 DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZENPEP DR 25,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZENPEP DR 25,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZENPEP DR 3,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZENPEP DR 3,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZENZEDI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZENZEDI 15 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZENZEDI 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZENZEDI 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZENZEDI 30 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZENZEDI 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZENZEDI 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZENZEDI 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZERIT 15MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZERIT 15MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZERIT 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover ZERIT 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZERIT 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZERIT 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZERIT 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZERIT 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZERIT 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZERIT 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZETIA 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PA cover ZETIA 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZIAGEN 20mg/mL 240 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZIAGEN 20mg/mL 240 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZIAGEN 300mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZIAGEN 300mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZIDOVUDINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZIDOVUDINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZIDOVUDINE 10MG/ML SYRUP ![Compare how all Medicare Part D PDP plans in PA cover ZIDOVUDINE 10MG/ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
Zidovudine 300mg/1 12 BOTTLE CASE / 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Zidovudine 300mg/1 12 BOTTLE CASE / 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZINECARD 250 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZINECARD 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZIOPTAN 0.0015% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover ZIOPTAN 0.0015% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon] ![Compare how all Medicare Part D PDP plans in PA cover ZIPRASIDONE HCL 20 MG CAPSULE [Geodon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon] ![Compare how all Medicare Part D PDP plans in PA cover ZIPRASIDONE HCL 40 MG CAPSULE [Geodon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon] ![Compare how all Medicare Part D PDP plans in PA cover ZIPRASIDONE HCL 60 MG CAPSULE [Geodon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon] ![Compare how all Medicare Part D PDP plans in PA cover ZIPRASIDONE HCL 80 MG CAPSULE [Geodon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
ZIRGAN 1.5mg/g 1 TUBE, WITH APPLICATOR per CARTON / 5 g in 1 TUBE, WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in PA cover ZIRGAN 1.5mg/g 1 TUBE, WITH APPLICATOR per CARTON / 5 g in 1 TUBE, WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX 250MG Z-PAK TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX 250MG Z-PAK TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX 600MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX IV 500MG VIAL 10 VIAL BOX ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX IV 500MG VIAL 10 VIAL BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX ORAL SUSP 100MG/5ML ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX ORAL SUSP 100MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX ORAL SUSP 200MG/5ML ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX ORAL SUSP 200MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZITHROMAX TRI-PAK 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZITHROMAX TRI-PAK 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZMAX 2g/60mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZMAX 2g/60mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZOFRAN 2MG/ML MDV VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZOFRAN 2MG/ML MDV VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZOFRAN 4mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover ZOFRAN 4mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZOFRAN 4MG/5ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in PA cover ZOFRAN 4MG/5ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZOFRAN 8 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOFRAN 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZOFRAN ODT 4MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOFRAN ODT 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZOFRAN ODT 8mg/1 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in PA cover ZOFRAN ODT 8mg/1 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZOHYDRO ER 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOHYDRO ER 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:100 /31Days |
ZOHYDRO ER 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOHYDRO ER 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:100 /31Days |
ZOHYDRO ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOHYDRO ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:100 /31Days |
ZOHYDRO ER 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOHYDRO ER 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:100 /31Days |
ZOHYDRO ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOHYDRO ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:100 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZOHYDRO ER 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOHYDRO ER 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:100 /31Days |
Zoledronic Acid 4 mg/5 ml vial ![Compare how all Medicare Part D PDP plans in PA cover Zoledronic Acid 4 mg/5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
zoledronic acid 5 mg/100 ml ![Compare how all Medicare Part D PDP plans in PA cover zoledronic acid 5 mg/100 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZOLINZA 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOLINZA 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZOLMITRIPTAN 2.5 MG ODT [Zomig, Zomig-ZMT] ![Compare how all Medicare Part D PDP plans in PA cover ZOLMITRIPTAN 2.5 MG ODT [Zomig, Zomig-ZMT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | Q:16 /31Days |
ZOLMITRIPTAN 2.5 MG TABLET [Zomig, Zomig-ZMT] ![Compare how all Medicare Part D PDP plans in PA cover ZOLMITRIPTAN 2.5 MG TABLET [Zomig, Zomig-ZMT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | Q:16 /31Days |
ZOLMITRIPTAN 5 MG ODT [Zomig, Zomig-ZMT] ![Compare how all Medicare Part D PDP plans in PA cover ZOLMITRIPTAN 5 MG ODT [Zomig, Zomig-ZMT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | Q:8 /31Days |
ZOLMITRIPTAN 5 MG TABLET [Zomig, Zomig-ZMT] ![Compare how all Medicare Part D PDP plans in PA cover ZOLMITRIPTAN 5 MG TABLET [Zomig, Zomig-ZMT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | Q:8 /31Days |
ZOLPIDEM TART ER 12.5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover ZOLPIDEM TART ER 12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZOLPIDEM TARTRATE 10MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover ZOLPIDEM TARTRATE 10MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
Zolpidem Tartrate 5mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Zolpidem Tartrate 5mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZOLPIDEM TARTRATE 6.25MG TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in PA cover ZOLPIDEM TARTRATE 6.25MG TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
Zometa 4mg/100mL 1 BOTTLE per CARTON / 100 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Zometa 4mg/100mL 1 BOTTLE per CARTON / 100 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZOMETA 4MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZOMETA 4MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZOMIG 2.5 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in PA cover ZOMIG 2.5 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:16 /31Days |
ZOMIG 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOMIG 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:16 /31Days |
ZOMIG 5 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in PA cover ZOMIG 5 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:8 /31Days |
ZOMIG 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOMIG 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:8 /31Days |
ZOMIG ZMT 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOMIG ZMT 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:16 /31Days |
ZOMIG ZMT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOMIG ZMT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:8 /31Days |
ZONALON 5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover ZONALON 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZONEGRAN 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZONEGRAN 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZONEGRAN 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZONEGRAN 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZONISAMIDE 100MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover ZONISAMIDE 100MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
Zonisamide 25mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Zonisamide 25mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZONISAMIDE 50MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover ZONISAMIDE 50MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZONTIVITY 2.08 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZONTIVITY 2.08 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Zorbtive 8.8mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in PA cover Zorbtive 8.8mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZORTRESS 0.25MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover ZORTRESS 0.25MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
Zortress 0.5mg/1 60 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover Zortress 0.5mg/1 60 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
Zortress 0.75mg/1 60 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover Zortress 0.75mg/1 60 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZOSTAVAX VIAL ![Compare how all Medicare Part D PDP plans in PA cover ZOSTAVAX VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZOSYN 2/0.25GM PRE-MIX BAG ![Compare how all Medicare Part D PDP plans in PA cover ZOSYN 2/0.25GM PRE-MIX BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Zosyn 3.0; 0.375g/15mL; g/15mL 10 VIAL, SINGLE-USE per CARTON / 3.375 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in PA cover Zosyn 3.0; 0.375g/15mL; g/15mL 10 VIAL, SINGLE-USE per CARTON / 3.375 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZOSYN 3/0.375GRAM 24 BAGS PKG ![Compare how all Medicare Part D PDP plans in PA cover ZOSYN 3/0.375GRAM 24 BAGS PKG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZOVIA 1/35-28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOVIA 1/35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZOVIA 1/50-28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOVIA 1/50-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $50.00 | None |
ZOVIRAX 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZOVIRAX 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZOVIRAX 200MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in PA cover ZOVIRAX 200MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZOVIRAX 400MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZOVIRAX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZOVIRAX 5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover ZOVIRAX 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZOVIRAX 5% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover ZOVIRAX 5% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ZYBAN 150MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover ZYBAN 150MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZYCLARA 2.5% CREAM PUMP ![Compare how all Medicare Part D PDP plans in PA cover ZYCLARA 2.5% CREAM PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZYCLARA 3.75% CREAM ![Compare how all Medicare Part D PDP plans in PA cover ZYCLARA 3.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZYFLO 600 MG FILMTAB (120 TABLETS) ![Compare how all Medicare Part D PDP plans in PA cover ZYFLO 600 MG FILMTAB (120 TABLETS).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ZYFLO CR 600 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZYFLO CR 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ZYKADIA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover ZYKADIA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZYLET 0.3%-0.5% SUSPENSION DROPS(FINAL DOSAGE FORM)(ML) ![Compare how all Medicare Part D PDP plans in PA cover ZYLET 0.3%-0.5% SUSPENSION DROPS(FINAL DOSAGE FORM)(ML).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZYLOPRIM 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZYLOPRIM 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZYLOPRIM 300 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZYLOPRIM 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in PA cover ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Zytiga 250mg/1 120 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Zytiga 250mg/1 120 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ZYVOX 100MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover ZYVOX 100MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ZYVOX 600MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover ZYVOX 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ZYVOX 600MG/300ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover ZYVOX 600MG/300ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |