2014 Medicare Part D Plan Formulary Information |
Humana Enhanced (PDP) (S5884-005-0)
Benefit Details
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The Humana Enhanced (PDP) (S5884-005-0) Formulary Drugs Starting with the Letter F in CMS PDP Region 6 which includes: PA WV Plan Monthly Premium: $46.10 Deductible: $0 Qualifies for LIS: No |
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FABRAZYME 35MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FABRAZYME 35MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FACTIVE 320 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FACTIVE 320 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FAMCICLOVIR 125MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
FAMCICLOVIR 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
FAMCICLOVIR 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
FAMOTIDINE 20MG PIGGYBACK ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 20MG PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FAMOTIDINE 20MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 20MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FAMOTIDINE 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 1 KIT in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 1 KIT in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 10mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 10mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 12mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 12mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 1mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 1mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 2mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 2mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 4mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 4mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 6mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 6mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FANAPT 8mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 8mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:60 /30Days |
FARESTON 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FARESTON 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
FASLODEX 50MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in PA cover FASLODEX 50MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
FazaClo 100mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FazaClo 100mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FazaClo 12.5mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FazaClo 12.5mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | S |
FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | S |
FAZACLO 200 MG TABLETS ORALLY DISINTEGRATING ![Compare how all Medicare Part D PDP plans in PA cover FAZACLO 200 MG TABLETS ORALLY DISINTEGRATING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | S |
FazaClo 25mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FazaClo 25mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | S |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FELBAMATE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FELBAMATE 600 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 600 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FELBATOL 400MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBATOL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FELBATOL 600MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBATOL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FELBATOL 600MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover FELBATOL 600MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FELODIPINE ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELODIPINE ER 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
FELODIPINE ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
FEMCON Fe 72 CARTON in 1 CASE / 5 CELLO PACK per CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT ![Compare how all Medicare Part D PDP plans in PA cover FEMCON Fe 72 CARTON in 1 CASE / 5 CELLO PACK per CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FEMRING 0.05MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in PA cover FEMRING 0.05MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:1 /90Days |
FEMRING 0.10MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in PA cover FEMRING 0.10MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:1 /90Days |
FENOFIBRATE 130 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 130 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
FENOFIBRATE 134MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 134MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
fenofibrate 145 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover fenofibrate 145 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
FENOFIBRATE 160mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 160mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
FENOFIBRATE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
FENOFIBRATE 43 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 43 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
fenofibrate 48 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover fenofibrate 48 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:60 /30Days |
Fenofibrate 54mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Fenofibrate 54mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:60 /30Days |
FENOFIBRATE 67MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 67MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
Fenofibric acid dr 135 mg capsule [TRILIPIX] ![Compare how all Medicare Part D PDP plans in PA cover Fenofibric acid dr 135 mg capsule [TRILIPIX].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
Fenofibric acid dr 45 mg capsule [TRILIPIX] ![Compare how all Medicare Part D PDP plans in PA cover Fenofibric acid dr 45 mg capsule [TRILIPIX].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:30 /30Days |
FENOPROFEN 600MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FENOPROFEN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:20 /30Days |
FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:20 /30Days |
FENTANYL 75 MCG/HR PATCH ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 75 MCG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:20 /30Days |
FENTANYL CITRATE 1600ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE 1600ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
FENTANYL CITRATE 200ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE 200ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:20 /30Days |
FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:20 /30Days |
FETZIMA 20-40 MG TITRATION PAK ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA 20-40 MG TITRATION PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:28 /28Days |
FETZIMA ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FETZIMA ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FETZIMA ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FETZIMA ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FINASTERIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FINASTERIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
FIRMAGON 20mg/mL 1 VIAL, GLASS per CARTON / 4 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in PA cover FIRMAGON 20mg/mL 1 VIAL, GLASS per CARTON / 4 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P |
FLAREX 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover FLAREX 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLAVOXATE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLAVOXATE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLECAINIDE ACETATE 100 MG TAB #60 EA ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 100 MG TAB #60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | None |
FLECAINIDE ACETATE 150 MG TAB 360 EA ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 150 MG TAB 360 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | None |
FLECAINIDE ACETATE 50 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | None |
FLECTOR PATCH ![Compare how all Medicare Part D PDP plans in PA cover FLECTOR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:60 /30Days |
FLONASE 0.05% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in PA cover FLONASE 0.05% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:16 /30Days |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:24 /30Days |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:24 /30Days |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:11 /30Days |
FLUCONAZOLE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 10MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 10MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
FLUCONAZOLE 150MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Fluconazole 200mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluconazole 200mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 40MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 40MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Fluconazole 50mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluconazole 50mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Flucytosine 250mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Flucytosine 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Flucytosine 500mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Flucytosine 500mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FLUDARABINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FLUDARABINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUNISOLIDE 29 MCG-0.025% SPR ![Compare how all Medicare Part D PDP plans in PA cover FLUNISOLIDE 29 MCG-0.025% SPR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:50 /30Days |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in PA cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:50 /30Days |
FLUOCINOLONE 0.01% BODY OIL ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% BODY OIL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.01% CREAM ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.01% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLUOCINOLONE 0.025% CREAM ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUOCINOLONE 0.025% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.025% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluocinonide 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUOROURACIL 2% TOPICAL SOLN ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 2% TOPICAL SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLUOROURACIL 5% TOP SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 5% TOP SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
fluorouracil 500 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in PA cover fluorouracil 500 mg/10 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLUOROURACIL CREA 5% ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL CREA 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUOXETINE 40MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE 40MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:60 /30Days |
FLUOXETINE CAPSULES 10MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE CAPSULES 10MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOXETINE DR 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE DR 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:4 /28Days |
FLUOXETINE HCL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | None |
FLUOXETINE HCL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
Fluoxetine Hydrochloride 20mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluoxetine Hydrochloride 20mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:120 /30Days |
FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HYDROCHLORIDE TABLETS 10MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUOXYMESTERONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUOXYMESTERONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLUPHENAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Fluphenazine Decanoate 25mg/mL ![Compare how all Medicare Part D PDP plans in PA cover Fluphenazine Decanoate 25mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE HCL 2.5MG/5ML ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLURBIPROFEN 0.03% EYE DROP ![Compare how all Medicare Part D PDP plans in PA cover FLURBIPROFEN 0.03% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLURBIPROFEN 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLURBIPROFEN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Flutamide 125mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Flutamide 125mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
Fluticasone Propionate 0.05mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluticasone Propionate 0.05mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | Q:16 /30Days |
FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in PA cover FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in PA cover FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:60 /30Days |
fluvoxamine er 100 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover fluvoxamine er 100 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
fluvoxamine er 150 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover fluvoxamine er 150 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
FLUVOXAMINE MALEATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE MALEATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:90 /30Days |
Fluvoxamine Maleate 25 mg tab ![Compare how all Medicare Part D PDP plans in PA cover Fluvoxamine Maleate 25 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:90 /30Days |
Fluvoxamine maleate 50mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluvoxamine maleate 50mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:90 /30Days |
FML FORTE 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover FML FORTE 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FML LIQUIFILM 0.1% EYE DROP ![Compare how all Medicare Part D PDP plans in PA cover FML LIQUIFILM 0.1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FML S.O.P. 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover FML S.O.P. 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FOCALIN XR 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FOCALIN XR 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
FOCALIN XR 15MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FOCALIN XR 15MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOCALIN XR 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FOCALIN XR 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
Focalin XR 25mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Focalin XR 25mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
FOCALIN XR 30MG CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover FOCALIN XR 30MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
Focalin XR 35mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Focalin XR 35mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
Focalin XR 40mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Focalin XR 40mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
FOCALIN XR 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FOCALIN XR 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:30 /30Days |
FOLOTYN 20mg/mL 1 VIAL, SINGLE-USE per CARTON / 2 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in PA cover FOLOTYN 20mg/mL 1 VIAL, SINGLE-USE per CARTON / 2 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Fomepizole 1g/mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PA cover Fomepizole 1g/mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Fondaparinux Sodium 10mg/0.8mL 2 SYRINGES per CARTON / 0.8 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 10mg/0.8mL 2 SYRINGES per CARTON / 0.8 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
Fondaparinux Sodium 2.5mg/0.5mL 2 SYRINGES per CARTON / 0.5 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 2.5mg/0.5mL 2 SYRINGES per CARTON / 0.5 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:14 /30Days |
Fondaparinux Sodium 5mg/4mL 2 SYRINGES per CARTON / 0.4 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 5mg/4mL 2 SYRINGES per CARTON / 0.4 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Fondaparinux Sodium 7.5mg/0.6mL 2 SYRINGES per CARTON / 0.6 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 7.5mg/0.6mL 2 SYRINGES per CARTON / 0.6 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
FORADIL AEROLIZER 12 MCG CAP ![Compare how all Medicare Part D PDP plans in PA cover FORADIL AEROLIZER 12 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | Q:60 /30Days |
Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | S Q:2 /28Days |
FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in PA cover FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:4 /28Days |
FOSCARNET 24MG/ML INFUS BTTL ![Compare how all Medicare Part D PDP plans in PA cover FOSCARNET 24MG/ML INFUS BTTL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | None |
FOSINOPRIL SODIUM 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FOSINOPRIL SODIUM 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FOSINOPRIL SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $0.00 | None |
FOSINOPRIL-HCTZ 10-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL-HCTZ 10-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | None |
FOSINOPRIL-HCTZ 20-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL-HCTZ 20-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $116.00 | None |
Fosphenytoin Sodium 50mg/mL 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PA cover Fosphenytoin Sodium 50mg/mL 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Fragmin 12500[iU]/0.5mL ![Compare how all Medicare Part D PDP plans in PA cover Fragmin 12500[iU]/0.5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
Fragmin 15000[iU]/0.6mL ![Compare how all Medicare Part D PDP plans in PA cover Fragmin 15000[iU]/0.6mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
Fragmin 18000[iU]/0.72mL ![Compare how all Medicare Part D PDP plans in PA cover Fragmin 18000[iU]/0.72mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1 ![Compare how all Medicare Part D PDP plans in PA cover FRAGMIN 25000UNITS/ML VIAL 3.8ML x 1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:2 /30Days |
FRAGMIN 2500UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in PA cover FRAGMIN 2500UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:14 /30Days |
FRAGMIN 5000UNITS SYRINGE 0.2ML x 10 ![Compare how all Medicare Part D PDP plans in PA cover FRAGMIN 5000UNITS SYRINGE 0.2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:14 /30Days |
FRAGMIN INJECTION 10000UNITS 1 X 10 SYR ![Compare how all Medicare Part D PDP plans in PA cover FRAGMIN INJECTION 10000UNITS 1 X 10 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
FRAGMIN INJECTION 7500UNT/ML ![Compare how all Medicare Part D PDP plans in PA cover FRAGMIN INJECTION 7500UNT/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:14 /30Days |
Furosemide 10mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 4 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 10mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 4 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
FUROSEMIDE 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Furosemide 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FUROSEMIDE 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
FUROSEMIDE 80MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 80MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
FUSILEV I.V. 50 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FUSILEV I.V. 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P |
FUZEON 90 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FUZEON 90 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
FYCOMPA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FYCOMPA 12 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FYCOMPA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FYCOMPA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FYCOMPA 6 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |
FYCOMPA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | P Q:30 /30Days |