2014 Medicare Part D Plan Formulary Information |
ADVANTAGE Enhanced (PPO) (H5508-001-0)
Benefit Details
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The ADVANTAGE Enhanced (PPO) (H5508-001-0) Formulary Drugs Starting with the Letter E in WABASH County, IN: CMS MA Region 13 which includes: IN Plan Monthly Premium: $98.00 Deductible: $0 |
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
edarbi 40mg/1 ![Compare how all Medicare Part D PDP plans in IN cover edarbi 40mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | S |
edarbi 80mg/1 ![Compare how all Medicare Part D PDP plans in IN cover edarbi 80mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | S |
EDARBYCLOR 40-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EDARBYCLOR 40-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EDARBYCLOR 40-25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EDARBYCLOR 40-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in IN cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EFFIENT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EFFIENT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EFFIENT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EFFIENT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in IN cover ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in IN cover ELIGARD 1 KIT per CARTON.](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 |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in IN cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in IN cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in IN cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Elitek 3 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in IN cover Elitek 3 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EMEND 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover EMEND 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P Q:30 /30Days |
EMEND CAPSULES 125MG 6 BLPK ![Compare how all Medicare Part D PDP plans in IN cover EMEND CAPSULES 125MG 6 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P Q:30 /30Days |
EMEND CAPSULES 80MG 2 BLPK ![Compare how all Medicare Part D PDP plans in IN cover EMEND CAPSULES 80MG 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P Q:4 /30Days |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in IN cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in IN cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](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 |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in IN cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in IN cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENALAPRIL MALEATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IN cover Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 25 MG/0.5 ML SYRINGE.](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 |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ENBREL 50mg/mL ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENDODAN TABLETS 325;4.8355MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover ENDODAN TABLETS 325;4.8355MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in IN cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in IN cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
ENGERIX-B 20 MCG/ML SYRN ![Compare how all Medicare Part D PDP plans in IN cover ENGERIX-B 20 MCG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | P |
ENOXAPARIN 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENOXAPARIN 120 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 120 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENOXAPARIN 150 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 150 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENOXAPARIN 30 MG/0.3 ML SYR ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 30 MG/0.3 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENOXAPARIN 300 MG/3 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 300 MG/3 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENOXAPARIN 40 MG/0.4 ML SYR ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 40 MG/0.4 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENOXAPARIN 60 MG/0.6 ML SYR ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 60 MG/0.6 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENOXAPARIN 80 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 80 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
entacapone 200 mg tablet [Comtan] ![Compare how all Medicare Part D PDP plans in IN cover entacapone 200 mg tablet [Comtan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
EPANED 1 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover EPANED 1 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in IN cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in IN cover EPIPEN JR 0.15MG AUTO-INJCT.](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 |
EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover EPIRUBICIN HCL INJECTION SOLUTION 2MG 1 X 25ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
EPIVIR 10 MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover EPIVIR 10 MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
EPIVIR HBV 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EPIVIR HBV 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Eplerenone 25mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Eplerenone 25mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
Eplerenone 50mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Eplerenone 50mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
EPROSARTAN MESYLATE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EPROSARTAN MESYLATE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
EPZICOM 600MG/300MG TABLETS ![Compare how all Medicare Part D PDP plans in IN cover EPZICOM 600MG/300MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
EQUETRO CAPSULES 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in IN cover EQUETRO CAPSULES 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EQUETRO CAPSULES 300MG 120 BOT ![Compare how all Medicare Part D PDP plans in IN cover EQUETRO CAPSULES 300MG 120 BOT.](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 |
EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT ![Compare how all Medicare Part D PDP plans in IN cover EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in IN cover ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ERGOLOID MESYLATES TABLETS 1MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover ERGOLOID MESYLATES TABLETS 1MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ERGOMAR 2 MG TABLET SL ![Compare how all Medicare Part D PDP plans in IN cover ERGOMAR 2 MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ERWINAZE 10,000 UNITS VIAL ![Compare how all Medicare Part D PDP plans in IN cover ERWINAZE 10,000 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ERYTHROCIN TAB 250MG ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROCIN TAB 250MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Erythromycin 2% solution ![Compare how all Medicare Part D PDP plans in IN cover Erythromycin 2% solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IN cover Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ERYTHROMYCIN ES 400 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN ES 400 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium] ![Compare how all Medicare Part D PDP plans in IN cover ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium] ![Compare how all Medicare Part D PDP plans in IN cover ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
Estazolam 1mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Estazolam 1mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Estazolam 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Estazolam 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ESTRACE VAG CREAM 0.1MG/GM ![Compare how all Medicare Part D PDP plans in IN cover ESTRACE VAG CREAM 0.1MG/GM.](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 |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | P |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | P |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | P |
Eszopiclone 1 mg tablet [Lunesta] ![Compare how all Medicare Part D PDP plans in IN cover Eszopiclone 1 mg tablet [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Eszopiclone 2 mg tablet [Lunesta] ![Compare how all Medicare Part D PDP plans in IN cover Eszopiclone 2 mg tablet [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Eszopiclone 3 mg tablet [Lunesta] ![Compare how all Medicare Part D PDP plans in IN cover Eszopiclone 3 mg tablet [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in IN cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Ethosuximide 250mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Ethosuximide 250mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in IN cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Etodolac 300 mg capsule ![Compare how all Medicare Part D PDP plans in IN cover Etodolac 300 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
Etodolac 400mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Etodolac 400mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
Etodolac 500mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Etodolac 500mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
ETOPOPHOS 100MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover ETOPOPHOS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IN cover Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Evista 60mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Evista 60mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
EXELON 13.3 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in IN cover EXELON 13.3 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in IN cover EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in IN cover EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |
EXFORGE 10MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXFORGE 10MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EXFORGE 10MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXFORGE 10MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EXFORGE 5MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXFORGE 5MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EXFORGE 5MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXFORGE 5MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Exforge HCT 10; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Exforge HCT 10; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Exforge HCT 10; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Exforge HCT 10; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Exforge HCT 10; 25; 320mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Exforge HCT 10; 25; 320mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
Exforge HCT 5; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Exforge HCT 5; 12.5; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in 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 |
Exforge HCT 5; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Exforge HCT 5; 25; 160mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $180.00 | None |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
EXTAVIA 15 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IN cover EXTAVIA 15 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
EXTENDED PHENYTOIN SODIUM CAPSULES 300 MG ![Compare how all Medicare Part D PDP plans in IN cover EXTENDED PHENYTOIN SODIUM CAPSULES 300 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None |