2014 Medicare Part D Plan Formulary Information |
EnvisionRxPlus Silver (PDP) (S7694-025-0)
Benefit Details
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The EnvisionRxPlus Silver (PDP) (S7694-025-0) Formulary Drugs Starting with the Letter C in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY Plan Monthly Premium: $33.40 Deductible: $310 Qualifies for LIS: Yes |
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CALCIPOTRIENE TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CALCIPOTRIENE TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in IA cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CALCITRIOL 0.25MCG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 0.25MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CALCITRIOL 0.5MCG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 0.5MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CALCITRIOL 1MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 1MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CALCITRIOL INJ 1MCG/ML ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL INJ 1MCG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in IA cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Camptosar 20mg/mL 1 VIAL, SINGLE-DOSE per CARTON / 5 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in IA cover Camptosar 20mg/mL 1 VIAL, SINGLE-DOSE per CARTON / 5 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CANCIDAS IV 50MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover CANCIDAS IV 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
CANCIDAS IV 70MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover CANCIDAS IV 70MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
candesartan-hctz 16-12.5 mg tablet ![Compare how all Medicare Part D PDP plans in IA cover candesartan-hctz 16-12.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
candesartan-hctz 32-12.5 mg tablet ![Compare how all Medicare Part D PDP plans in IA cover candesartan-hctz 32-12.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
candesartan-hctz 32-25 mg ![Compare how all Medicare Part D PDP plans in IA cover candesartan-hctz 32-25 mg.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:30 /30Days |
CAPRELSA 100mg/1 30 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover CAPRELSA 100mg/1 30 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:60 /30Days |
CAPRELSA 300mg/1 30 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover CAPRELSA 300mg/1 30 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
CAPTOPRIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CAPTOPRIL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CAPTOPRIL 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CAPTOPRIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Captopril and Hydrochlorothiazide 25; 15mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Captopril and Hydrochlorothiazide 25; 15mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Captopril and Hydrochlorothiazide 25; 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Captopril and Hydrochlorothiazide 25; 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Captopril and Hydrochlorothiazide 50; 15mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Captopril and Hydrochlorothiazide 50; 15mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Captopril and Hydrochlorothiazide 50; 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Captopril and Hydrochlorothiazide 50; 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CARBAMAZEPINE 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carbamazepine 100mg, CHEWABLE 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Carbamazepine 100mg, CHEWABLE 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carbamazepine 100mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Carbamazepine 100mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carbamazepine 200mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Carbamazepine 200mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carbamazepine 300mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Carbamazepine 300mg/1 120 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBAMAZEPINE TABLET USP 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE TABLET USP 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBAMAZEPINE XR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE XR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBAMAZEPINE XR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE XR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;250MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;250MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA-LEVO ER 25-100 TAB ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO ER 25-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA-LEVO ER 50-200 TAB ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO ER 50-200 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA/LEVO 10/100 TABLET ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA/LEVO 10/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA/LEVO 25/100 TABLET ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA/LEVO 25/100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARBIDOPA/LEVO 25/250 TABLET ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA/LEVO 25/250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carboplatin 10mg/mL ![Compare how all Medicare Part D PDP plans in IA cover Carboplatin 10mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CARIMUNE NF 3GM VIAL ![Compare how all Medicare Part D PDP plans in IA cover CARIMUNE NF 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in IA cover CARTEOLOL HCL OPHTHALMIC SOLUTION USP 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CARTIA XT 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carvedilol 12.5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Carvedilol 12.5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carvedilol 25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Carvedilol 25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carvedilol 3.125mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Carvedilol 3.125mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Carvedilol 6.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Carvedilol 6.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFACLOR 250 MG CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover CEFACLOR 250 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFACLOR 500 MG CAPSULES ![Compare how all Medicare Part D PDP plans in IA cover CEFACLOR 500 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFACLOR ER 500MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in IA cover CEFACLOR ER 500MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CEFAZOLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in IA cover CEFAZOLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE ![Compare how all Medicare Part D PDP plans in IA cover Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CEFAZOLIN 1GM/D5W BAG ![Compare how all Medicare Part D PDP plans in IA cover CEFAZOLIN 1GM/D5W BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CEFAZOLIN 500MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover CEFAZOLIN 500MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IA cover CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CEFDINIR CAPSULES 300MG (60 CT) ![Compare how all Medicare Part D PDP plans in IA cover CEFDINIR CAPSULES 300MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in IA cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFEPIME INJ 1GM 20ML APX 10x1G VIAL ![Compare how all Medicare Part D PDP plans in IA cover CEFEPIME INJ 1GM 20ML APX 10x1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Cefoxitin 1g/1 10 POWDER per CARTON ![Compare how all Medicare Part D PDP plans in IA cover Cefoxitin 1g/1 10 POWDER per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Cefoxitin 2g/1 10 POWDER per CARTON ![Compare how all Medicare Part D PDP plans in IA cover Cefoxitin 2g/1 10 POWDER per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFOXITIN FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CEFOXITIN FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFPODOXIME 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFPODOXIME 200 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFPODOXIME 50 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 50 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT) ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME PROXETIL FILM COATED TABLET 100MG (20 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFTRIAXONE 10GM VIAL ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 10GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFTRIAXONE 250 MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Ceftriaxone Sodium 500mg/1 ![Compare how all Medicare Part D PDP plans in IA cover Ceftriaxone Sodium 500mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFUROXIME 750MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME 750MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
cefuroxime axetil 250mg/1 ![Compare how all Medicare Part D PDP plans in IA cover cefuroxime axetil 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFUROXIME AXETIL 500 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME AXETIL 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFUROXIME FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CELEBREX 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CELEBREX 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
CELEBREX 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CELEBREX 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
CELEBREX 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CELEBREX 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
CELEBREX 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CELEBREX 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
CELLCEPT 200MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IA cover CELLCEPT 200MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CELONTIN 300MG KAPSEAL ![Compare how all Medicare Part D PDP plans in IA cover CELONTIN 300MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
Cephalexin 125mg/5mL 200 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Cephalexin 125mg/5mL 200 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEPHALEXIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEPHALEXIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEPHALEXIN 250MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 250MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEPHALEXIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEPHALEXIN CAPSULES 500MG (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN CAPSULES 500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CEREZYME INJ 200UNIT ![Compare how all Medicare Part D PDP plans in IA cover CEREZYME INJ 200UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
CERVARIX VACCINE SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover CERVARIX VACCINE SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
CETIRIZINE HCL 1 MG/ML SYRUP ![Compare how all Medicare Part D PDP plans in IA cover CETIRIZINE HCL 1 MG/ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHANTIX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHANTIX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P Q:56 /28Days |
CHANTIX 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in IA cover CHANTIX 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P Q:53 /28Days |
CHANTIX 1MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHANTIX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P Q:168 /84Days |
CHLORAMPHEN NA SUCC 1GM VL ![Compare how all Medicare Part D PDP plans in IA cover CHLORAMPHEN NA SUCC 1GM VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL TABLET 12.5-5MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | P |
CHLORDIAZEPOXIDE HCL 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE HCL 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORDIAZEPOXIDE HCL 25mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE HCL 25mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
CHLORDIAZEPOXIDE HCL 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE HCL 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH ![Compare how all Medicare Part D PDP plans in IA cover CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHLOROQUINE PH 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLOROQUINE PH 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT) ![Compare how all Medicare Part D PDP plans in IA cover CHLOROQUINE PHOSPHATE 250MG TABLET (50 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHLOROTHIAZIDE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLOROTHIAZIDE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CHLOROTHIAZIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLOROTHIAZIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CHLORPROMAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CHLORPROMAZINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CHLORPROMAZINE 25MG/ML AMP ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 25MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | P |
CHLORPROMAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORPROMAZINE HCL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE HCL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Chlorpromazine Hydrochloride 100mg SUGAR COATED 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Chlorpromazine Hydrochloride 100mg SUGAR COATED 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Chlorpropamide 100mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Chlorpropamide 100mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Chlorpropamide 250mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Chlorpropamide 250mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHLORTHALIDONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover CHLORTHALIDONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHLORTHALIDONE 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover CHLORTHALIDONE 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in IA cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Cialis 2.5mg/1 2 BLISTER PACK per CARTON / 15 FILM COATED TABLETS in BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Cialis 2.5mg/1 2 BLISTER PACK per CARTON / 15 FILM COATED TABLETS in BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P Q:30 /30Days |
Cialis 5mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Cialis 5mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P Q:30 /30Days |
Ciclopirox 7.7mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Ciclopirox 7.7mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CICLOPIROX 8% TOPICAL SOLUTION NAIL LACQUER 6.6ML BOT ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX 8% TOPICAL SOLUTION NAIL LACQUER 6.6ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CICLOPIROX GEL ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Ciclopirox Olamine 7.7mg/g 1 TUBE in 1 TUBE / 15 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IA cover Ciclopirox Olamine 7.7mg/g 1 TUBE in 1 TUBE / 15 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Cilostazol 50mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Cilostazol 50mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CILOSTAZOL TABLET 100MG (60 CT) ![Compare how all Medicare Part D PDP plans in IA cover CILOSTAZOL TABLET 100MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CIPROFLOXACIN 0.3% EYE DROP ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN 0.3% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CIPROFLOXACIN 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Ciprofloxacin 400mg/40mL 1 VIAL per CARTON / 40 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in IA cover Ciprofloxacin 400mg/40mL 1 VIAL per CARTON / 40 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Ciprofloxacin ER 212.6; 287.5mg/1; mg/1 50 TABLET, FILM COATED, in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Ciprofloxacin ER 212.6; 287.5mg/1; mg/1 50 TABLET, FILM COATED, in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Ciprofloxacin ER 425.2; 574.9mg/1; mg/1 50 TABLET, FILM COATED, in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Ciprofloxacin ER 425.2; 574.9mg/1; mg/1 50 TABLET, FILM COATED, in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CIPROFLOXACIN HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPROFLOXACIN HCL 500 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN HCL 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CIPROFLOXACIN TABLETS 750MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN TABLETS 750MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Cisplatin 100mg/100mL 1 VIAL per CARTON / 100 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in IA cover Cisplatin 100mg/100mL 1 VIAL per CARTON / 100 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CITALOPRAM HBR 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HBR 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HBR ORAL SOLUTION 10MG 240ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HYDROBROMIDE TABLETS 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CITOLOPRAM HBR 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover CITOLOPRAM HBR 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
cladribine 10 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in IA cover cladribine 10 mg/10 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CLARITHROMYCIN 250MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CLARITHROMYCIN 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLARITHROMYCIN 500MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CLARITHROMYCIN 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Clindacin PAC 10mg/1 1 JAR in 1 KIT / 69 SWAB in 1 JAR ![Compare how all Medicare Part D PDP plans in IA cover Clindacin PAC 10mg/1 1 JAR in 1 KIT / 69 SWAB in 1 JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN 150MG/ML ADDVAN ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN 150MG/ML ADDVAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
CLINDAMYCIN HCL 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN HCL 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLINDAMYCIN HCL 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN HCL 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLINDAMYCIN PEDIATR 75 MG/5 ML ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PEDIATR 75 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
clindamycin phosphate 10mg/mL 1 BOTTLE per CARTON / 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover clindamycin phosphate 10mg/mL 1 BOTTLE per CARTON / 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Clindamycin Phosphate and Benzoyl Peroxide 1 KIT ![Compare how all Medicare Part D PDP plans in IA cover Clindamycin Phosphate and Benzoyl Peroxide 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLINIMIX 2.75%/5% INJECTION 1000ML BAG ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 2.75%/5% INJECTION 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX 4.25/10 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 4.25/10 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINIMIX 4.25/20 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 4.25/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX 4.25/25 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 4.25/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX 4.25/5 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 4.25/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX 5/15 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 5/15 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX 5/20 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 5/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX 5/25 SULFITE FREE INJECTIONS 1035MG-420MEQ 1000ML BAG ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX 5/25 SULFITE FREE INJECTIONS 1035MG-420MEQ 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX E 2.75/10 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 2.75/10 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX E 2.75/5 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 2.75/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX E 4.25/25 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 4.25/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX E 4.25/5 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 4.25/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX E 5/20 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 5/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINIMIX E 5/25 SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 5/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLINIMIX E 5%/15% INJECTION 2000ML BAG ![Compare how all Medicare Part D PDP plans in IA cover CLINIMIX E 5%/15% INJECTION 2000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOBETASOL E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Clobetasol Propionate 0.4625mg/mL 1 BOTTLE per CARTON / 50 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Clobetasol Propionate 0.4625mg/mL 1 BOTTLE per CARTON / 50 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOLAR 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover CLOLAR 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
CLOMIPRAMINE HCL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLOMIPRAMINE HCL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CLOMIPRAMINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLOMIPRAMINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CLOMIPRAMINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLOMIPRAMINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
Clonazepam 0.125mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 0.125mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Clonazepam 0.25mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 0.25mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonazepam 0.5mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 0.5mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonazepam 0.5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 0.5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonazepam 1mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 1mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonazepam 1mg/1 90 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 1mg/1 90 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonazepam 2mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 2mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonazepam 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Clonazepam 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
Clonidine 0.1mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in IA cover Clonidine 0.1mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | S |
Clonidine 0.2mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in IA cover Clonidine 0.2mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | S |
Clonidine 0.3mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in IA cover Clonidine 0.3mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | S |
CLONIDINE HCL 0.2MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL 0.2MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLONIDINE HCL TABLET 0.1MG (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL TABLET 0.1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLONIDINE HCL TABLET 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL TABLET 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOPIDOGREL 300 MG tablet ![Compare how all Medicare Part D PDP plans in IA cover CLOPIDOGREL 300 MG tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | Q:1 /30Days |
CLOPIDOGREL TAB 75MG ![Compare how all Medicare Part D PDP plans in IA cover CLOPIDOGREL TAB 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | Q:30 /30Days |
CLORAZEPATE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CLORAZEPATE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:120 /30Days |
Clorazepate Dipotassium 3.75mg/1 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Clorazepate Dipotassium 3.75mg/1 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:90 /30Days |
Clorazepate Dipotassium 7.5mg/1 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Clorazepate Dipotassium 7.5mg/1 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | Q:90 /30Days |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOTRIMAZOLE 10MG TROCHE ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE 10MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE SOLUTION TOPICAL 1% 30ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Clozapine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Clozapine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOZAPINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOZAPINE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CLOZAPINE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
COLCRYS 0.6 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover COLCRYS 0.6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
COLESTIPOL HCL 1G TABLET ![Compare how all Medicare Part D PDP plans in IA cover COLESTIPOL HCL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
COLESTIPOL HYDROCHLORIDE 5g/1 100 SUSPENSION in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover COLESTIPOL HYDROCHLORIDE 5g/1 100 SUSPENSION in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
colistimethate 150mg/2mL 1 VIAL per CARTON / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in IA cover colistimethate 150mg/2mL 1 VIAL per CARTON / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE ![Compare how all Medicare Part D PDP plans in IA cover COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
COMBIGAN 0.2%-0.5% DROPS ![Compare how all Medicare Part D PDP plans in IA cover COMBIGAN 0.2%-0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COMBIVENT RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in IA cover COMBIVENT RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | Q:8 /30Days |
COMETRIQ 100 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in IA cover COMETRIQ 100 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
COMETRIQ 140 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in IA cover COMETRIQ 140 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
COMETRIQ 60 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in IA cover COMETRIQ 60 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in IA cover COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
COMPRO 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in IA cover COMPRO 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
COMTAN 200MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover COMTAN 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
COMVAX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in IA cover COMVAX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | None |
CONSTULOSE 10 GM/15 ML SOLN ![Compare how all Medicare Part D PDP plans in IA cover CONSTULOSE 10 GM/15 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in IA cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
COPAXONE 40 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover COPAXONE 40 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COSMEGEN 0.5 MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover COSMEGEN 0.5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | P |
Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT ![Compare how all Medicare Part D PDP plans in IA cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
CREON DR 36,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CREON DR 36,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | Q:450 /30Days |
CRIXIVAN 400mg, 180 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover CRIXIVAN 400mg, 180 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | Q:270 /30Days |
CROMOLYN NEBULIZER SOLUTION 20MG/2ML ![Compare how all Medicare Part D PDP plans in IA cover CROMOLYN NEBULIZER SOLUTION 20MG/2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $30.00 | P |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in IA cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IA cover CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cyclobenzaprine Hydrochloride 5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Cyclobenzaprine Hydrochloride 5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYCLOPHOSPHAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CYCLOPHOSPHAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYCLOPHOSPHAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CYCLOPHOSPHAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYCLOSET 0.8MG TABLETS ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSET 0.8MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
45% | N/A | S |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
Cyclosporine 100mg/1 30 BLISTER PACK per CARTON / 1 CAPSULE, LIQUID FILLED per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Cyclosporine 100mg/1 30 BLISTER PACK per CARTON / 1 CAPSULE, LIQUID FILLED per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
Cyclosporine 25mg/1 30 BLISTER PACK per CARTON / 1 CAPSULE, LIQUID FILLED per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Cyclosporine 25mg/1 30 BLISTER PACK per CARTON / 1 CAPSULE, LIQUID FILLED per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | None |
Cyclosporine 50mg/1 30 BLISTER PACK per CARTON / 1 CAPSULE, LIQUID FILLED per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Cyclosporine 50mg/1 30 BLISTER PACK per CARTON / 1 CAPSULE, LIQUID FILLED per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYPROHEPTADINE HCL 4 MG ![Compare how all Medicare Part D PDP plans in IA cover CYPROHEPTADINE HCL 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL ![Compare how all Medicare Part D PDP plans in IA cover CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYTARABINE 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover CYTARABINE 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYTARABINE 500MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover CYTARABINE 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |
CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD ![Compare how all Medicare Part D PDP plans in IA cover CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
25% | N/A | P |