2014 Medicare Part D Plan Formulary Information |
MedicareBlue Rx Standard (PDP) (S5743-001-0)
Benefit Details
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The MedicareBlue Rx Standard (PDP) (S5743-001-0) Formulary Drugs Starting with the Letter E in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY Plan Monthly Premium: $41.90 Deductible: $160 Qualifies for LIS: No |
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 |
E.E.S. GRAN SUS 200/5ML ![Compare how all Medicare Part D PDP plans in MT cover E.E.S. GRAN SUS 200/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in MT cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in MT cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | Q:30 /30Days |
EFFIENT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EFFIENT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | None |
EFFIENT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EFFIENT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | 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 MT 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) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ELELYSO 200 UNITS VIAL ![Compare how all Medicare Part D PDP plans in MT cover ELELYSO 200 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ELIDEL 1% CREAM ![Compare how all Medicare Part D PDP plans in MT cover ELIDEL 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | S |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MT cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MT cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | 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 MT cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ELIGARD 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MT cover ELIGARD 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
Elitek 3 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in MT cover Elitek 3 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
Ella 30mg/1 1 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MT cover Ella 30mg/1 1 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EMEND 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover EMEND 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | P |
EMEND CAPSULES 125MG 6 BLPK ![Compare how all Medicare Part D PDP plans in MT cover EMEND CAPSULES 125MG 6 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | P |
EMEND CAPSULES 80MG 2 BLPK ![Compare how all Medicare Part D PDP plans in MT cover EMEND CAPSULES 80MG 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | P |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in MT cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | P |
Emoquette 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MT cover Emoquette 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in MT cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | 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 MT cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in MT cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MT cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | Q:850 /30Days |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | Q:30 /30Days |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in MT cover ENALAPRIL MALEATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MT cover Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover ENALAPRIL MALEATE-HCTZ 10MG-25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MT cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in MT cover ENBREL 25 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
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 MT cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ENBREL 50mg/mL ![Compare how all Medicare Part D PDP plans in MT cover ENBREL 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | Q:180 /30Days |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in MT cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | Q:360 /30Days |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | Q:240 /30Days |
ENDODAN TABLETS 325;4.8355MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in MT cover ENDODAN TABLETS 325;4.8355MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:360 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in MT cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in MT cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ENGERIX-B 20 MCG/ML SYRN ![Compare how all Medicare Part D PDP plans in MT cover ENGERIX-B 20 MCG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ENOXAPARIN 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /90Days |
ENOXAPARIN 120 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 120 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:24 /90Days |
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 MT cover ENOXAPARIN 150 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /90Days |
ENOXAPARIN 30 MG/0.3 ML SYR ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 30 MG/0.3 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:9 /90Days |
ENOXAPARIN 300 MG/3 ML VIAL ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 300 MG/3 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /90Days |
ENOXAPARIN 40 MG/0.4 ML SYR ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 40 MG/0.4 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:12 /90Days |
ENOXAPARIN 60 MG/0.6 ML SYR ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 60 MG/0.6 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:18 /90Days |
ENOXAPARIN 80 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in MT cover ENOXAPARIN 80 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:24 /90Days |
entacapone 200 mg tablet [Comtan] ![Compare how all Medicare Part D PDP plans in MT cover entacapone 200 mg tablet [Comtan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in MT cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Epinastine HCl 0.5mg/mL ![Compare how all Medicare Part D PDP plans in MT cover Epinastine HCl 0.5mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in MT cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | None |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in MT cover EPIPEN JR 0.15MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | 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 MT 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 |
$18.00 | $36.00 | None |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
EPIVIR 10 MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MT cover EPIVIR 10 MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:960 /30Days |
EPIVIR HBV 100MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EPIVIR HBV 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MT cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | None |
Eplerenone 25mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover Eplerenone 25mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Eplerenone 50mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover Eplerenone 50mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in MT cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MT cover EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
EPOGEN 3000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in MT cover EPOGEN 3000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in MT cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in MT cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
EPROSARTAN MESYLATE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EPROSARTAN MESYLATE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /30Days |
EPZICOM 600MG/300MG TABLETS ![Compare how all Medicare Part D PDP plans in MT cover EPZICOM 600MG/300MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | Q:30 /30Days |
EQUETRO CAPSULES 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in MT cover EQUETRO CAPSULES 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EQUETRO CAPSULES 300MG 120 BOT ![Compare how all Medicare Part D PDP plans in MT cover EQUETRO CAPSULES 300MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT ![Compare how all Medicare Part D PDP plans in MT cover EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in MT cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P Q:30 /30Days |
ERRIN 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ERRIN 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ERWINAZE 10,000 UNITS VIAL ![Compare how all Medicare Part D PDP plans in MT cover ERWINAZE 10,000 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in MT cover ERY 2% PADS 2% 60 PADS JAR.](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 |
ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERY-TAB TAB 250MG EC ![Compare how all Medicare Part D PDP plans in MT cover ERY-TAB TAB 250MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERY-TAB TAB 333MG EC ![Compare how all Medicare Part D PDP plans in MT cover ERY-TAB TAB 333MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERYPED 200 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MT cover ERYPED 200 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERYPED 400 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MT cover ERYPED 400 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in MT cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ERYTHROCIN TAB 250MG ![Compare how all Medicare Part D PDP plans in MT cover ERYTHROCIN TAB 250MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
Erythromycin 2% solution ![Compare how all Medicare Part D PDP plans in MT cover Erythromycin 2% solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE ![Compare how all Medicare Part D PDP plans in MT cover ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in MT cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in MT cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in MT cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /30Days |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in MT cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:30 /30Days |
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro] ![Compare how all Medicare Part D PDP plans in MT cover ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | Q:600 /30Days |
ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium] ![Compare how all Medicare Part D PDP plans in MT cover ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium] ![Compare how all Medicare Part D PDP plans in MT cover ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ESTRACE VAG CREAM 0.1MG/GM ![Compare how all Medicare Part D PDP plans in MT cover ESTRACE VAG CREAM 0.1MG/GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C ![Compare how all Medicare Part D PDP plans in MT cover Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL TDS 0.025 MG/DAY ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TDS 0.025 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL TDS 0.0375 MG/DAY ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TDS 0.0375 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL TDS 0.05 MG/DAY ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TDS 0.05 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL TDS 0.06 MG/DAY ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TDS 0.06 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL TDS 0.075 MG/DAY ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TDS 0.075 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL TDS 0.1 MG/DAY ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL TDS 0.1 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTROPIPATE 0.625(0.75 MG) TABLET ![Compare how all Medicare Part D PDP plans in MT cover ESTROPIPATE 0.625(0.75 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTROPIPATE 1.25(1.5 MG) TABLET ![Compare how all Medicare Part D PDP plans in MT cover ESTROPIPATE 1.25(1.5 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ESTROPIPATE 2.5(3 MG) TABLET ![Compare how all Medicare Part D PDP plans in MT cover ESTROPIPATE 2.5(3 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | P |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in MT cover Ethambutol Hydrochloride 100mg/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 |
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6 ![Compare how all Medicare Part D PDP plans in MT cover ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21 ![Compare how all Medicare Part D PDP plans in MT cover ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Ethosuximide 250mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover Ethosuximide 250mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in MT cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ETIDRONATE DISODIUM 400MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MT cover ETIDRONATE DISODIUM 400MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ETIDRONATE DISODIUM TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in MT cover ETIDRONATE DISODIUM TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MT cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Etodolac 300 mg capsule ![Compare how all Medicare Part D PDP plans in MT cover Etodolac 300 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MT cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
Etodolac 400mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover Etodolac 400mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MT cover ETODOLAC 500MG TABLET SR 24HR.](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 |
Etodolac 500mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover Etodolac 500mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MT cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$18.00 | $36.00 | None |
ETOPOPHOS 100MG VIAL ![Compare how all Medicare Part D PDP plans in MT cover ETOPOPHOS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
Evista 60mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MT cover Evista 60mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | None |
EXELON 13.3 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in MT cover EXELON 13.3 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in MT cover EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in MT cover EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MT 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 |
$18.00 | $36.00 | None |
EXFORGE 10MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXFORGE 10MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
EXFORGE 10MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXFORGE 10MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
EXFORGE 5MG-160MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXFORGE 5MG-160MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EXFORGE 5MG-320MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXFORGE 5MG-320MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
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 MT 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) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
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 MT 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) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
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 MT 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) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
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 MT 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) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
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 MT 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) |
3 |
Preferred Brand |
$38.00 | $76.00 | Q:30 /30Days |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MT cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
48% | 48% | None |
EXTENDED PHENYTOIN SODIUM CAPSULES 300 MG ![Compare how all Medicare Part D PDP plans in MT cover EXTENDED PHENYTOIN SODIUM CAPSULES 300 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |