2015 Medicare Part D Plan Formulary Information |
Rocky Mountain Standard Plan + Rx (Cost) (H0602-022-0)
Benefit Details
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The Rocky Mountain Standard Plan + Rx (Cost) (H0602-022-0) Formulary Drugs Starting with the Letter A in DENVER County, CO: CMS MA Region 20 which includes: CO Plan Monthly Premium: $168.00 Deductible: $0 |
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
A-HYDROCORT 100MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover A-HYDROCORT 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in CO cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ABELCENT INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in CO cover ABELCENT INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ABILIFY 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY 15MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY 20MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY 2MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY 30MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY 5MG TABLET (OTSUKA) ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY 5MG TABLET (OTSUKA).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABILIFY MAINTENA ER 300 MG SYR ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY MAINTENA ER 300 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY MAINTENA ER 300 MG VL ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY MAINTENA ER 300 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABILIFY MAINTENA ER 400 MG SYR ![Compare how all Medicare Part D PDP plans in CO cover ABILIFY MAINTENA ER 400 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in CO cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACARBOSE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACARBOSE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACARBOSE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACARBOSE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Acarbose 50mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Acarbose 50mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACCOLATE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCOLATE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCOLATE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCOLATE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCUPRIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCUPRIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACCUPRIL 20MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCUPRIL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCUPRIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCUPRIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCUPRIL 5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCUPRIL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCURETIC 10-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCURETIC 10-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCURETIC 20-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCURETIC 20-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACCURETIC 20-25MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACCURETIC 20-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACEBUTOLOL 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ACEBUTOLOL 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACEBUTOLOL 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ACEBUTOLOL 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACELLULAR PERTUSSIS VACCINE 50 UNT/ML / DIPHTHERIA TOXOID VACCINE 50 UNT/ML / TETANUS TOXOID VACCINE ![Compare how all Medicare Part D PDP plans in CO cover ACELLULAR PERTUSSIS VACCINE 50 UNT/ML / DIPHTHERIA TOXOID VACCINE 50 UNT/ML / TETANUS TOXOID VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ACETAMINOPHEN AND CODEINE PHOSPHATE SOLUTION ORAL USP 120;12MG/5ML;MG/ 12.5 ML CUPUD ![Compare how all Medicare Part D PDP plans in CO cover ACETAMINOPHEN AND CODEINE PHOSPHATE SOLUTION ORAL USP 120;12MG/5ML;MG/ 12.5 ML CUPUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT) ![Compare how all Medicare Part D PDP plans in CO cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET 300MG-30MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETASOL HC SOLUTION 10ML 10 ML BOT ![Compare how all Medicare Part D PDP plans in CO cover ACETASOL HC SOLUTION 10ML 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Acetazolamide 500mg/5mL 1 VIAL in 1 CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover Acetazolamide 500mg/5mL 1 VIAL in 1 CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETAZOLAMIDE ER CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in CO cover ACETAZOLAMIDE ER CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETIC ACID 2% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in CO cover ACETIC ACID 2% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in CO cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN ![Compare how all Medicare Part D PDP plans in CO cover ACETYLCYSTEINE 20% VIAL 3 X 30ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in CO cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in CO cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in CO cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTEMRA 162 MG/0.9 ML SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ACTEMRA 162 MG/0.9 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ACTEMRA INJECTION 200MG/10ML ![Compare how all Medicare Part D PDP plans in CO cover ACTEMRA INJECTION 200MG/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ACTHIB VACCINE VIAL 10-24UNT/5ML ![Compare how all Medicare Part D PDP plans in CO cover ACTHIB VACCINE VIAL 10-24UNT/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ACTIGALL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ACTIGALL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ACTIVELLA 0.5-0.1MG TABLET 28 DLPK ![Compare how all Medicare Part D PDP plans in CO cover ACTIVELLA 0.5-0.1MG TABLET 28 DLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTIVELLA 1-0.5MG TABLET 28 DLPK ![Compare how all Medicare Part D PDP plans in CO cover ACTIVELLA 1-0.5MG TABLET 28 DLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Actonel 150mg 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 1 FILM COATED TABLETS in TRAY ![Compare how all Medicare Part D PDP plans in CO cover Actonel 150mg 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 1 FILM COATED TABLETS in TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Actonel 30mg 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Actonel 30mg 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Actonel 35mg 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 4 FILM COATED TABLETS in TRAY ![Compare how all Medicare Part D PDP plans in CO cover Actonel 35mg 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 4 FILM COATED TABLETS in TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:4 /28Days |
Actonel 5mg 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Actonel 5mg 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOPLUS MET 15MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACTOPLUS MET 15MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOPLUS MET 15MG/850MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACTOPLUS MET 15MG/850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOPLUS MET XR TABLETS ER 15;1000 MG;MG ![Compare how all Medicare Part D PDP plans in CO cover ACTOPLUS MET XR TABLETS ER 15;1000 MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOPLUS MET XR TABLETS ER 30;1000 MG;MG ![Compare how all Medicare Part D PDP plans in CO cover ACTOPLUS MET XR TABLETS ER 30;1000 MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOS 15 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACTOS 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOS 30 MG 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ACTOS 30 MG 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACTOS 45MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACTOS 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACULAR 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover ACULAR 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ACULAR LS 0.4% OPHTH SOL ![Compare how all Medicare Part D PDP plans in CO cover ACULAR LS 0.4% OPHTH SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACUVAIL 0.45% OPHTH SOLUTION #30X0.4 EA ![Compare how all Medicare Part D PDP plans in CO cover ACUVAIL 0.45% OPHTH SOLUTION #30X0.4 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Acyclovir 200mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Acyclovir 200mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Acyclovir 200mg/5mL 473 mL BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Acyclovir 200mg/5mL 473 mL BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Acyclovir 400 MG ![Compare how all Medicare Part D PDP plans in CO cover Acyclovir 400 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Acyclovir 5% Ointment ![Compare how all Medicare Part D PDP plans in CO cover Acyclovir 5% Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in CO cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
ACZONE 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in CO cover ACZONE 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in CO cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Adalat CC 30mg 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Adalat CC 30mg 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Adalat CC 60mg 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Adalat CC 60mg 1000 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Adalat CC 90mg 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Adalat CC 90mg 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in CO cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADAPALENE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in CO cover ADAPALENE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ADAPALENE 0.1% GEL ![Compare how all Medicare Part D PDP plans in CO cover ADAPALENE 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Adapalene 0.3% gel ![Compare how all Medicare Part D PDP plans in CO cover Adapalene 0.3% gel.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ADCIRCA TABLETS 20MG 60 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ADCIRCA TABLETS 20MG 60 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADDERALL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL XR 10MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL XR 10MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADDERALL XR 15MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL XR 15MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL XR 20MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL XR 20MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL XR 25MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL XR 25MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL XR 30MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL XR 30MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADDERALL XR 5MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover ADDERALL XR 5MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera] ![Compare how all Medicare Part D PDP plans in CO cover ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Adrenalin 1 mg/ml vial ![Compare how all Medicare Part D PDP plans in CO cover Adrenalin 1 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ADRUCIL 50mg/mL 10 VIAL in 1 TRAY / 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover ADRUCIL 50mg/mL 10 VIAL in 1 TRAY / 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in CO cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:60 /30Days |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in CO cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:60 /30Days |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in CO cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:60 /30Days |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in CO cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:12 /30Days |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in CO cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:12 /30Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in CO cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:12 /30Days |
ADVICOR ER 20-750MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in CO cover ADVICOR ER 20-750MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADVICOR ER TABLETS 20;1000MG;MG 90 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ADVICOR ER TABLETS 20;1000MG;MG 90 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ADVICOR ER TABLETS 20;500MG;MG 90 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ADVICOR ER TABLETS 20;500MG;MG 90 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADVICOR ER TABLETS 40;1000MG;MG 90 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ADVICOR ER TABLETS 40;1000MG;MG 90 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AEROSPAN 80 MCG INHALER ![Compare how all Medicare Part D PDP plans in CO cover AEROSPAN 80 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AFINITOR TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in CO cover AFINITOR TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AFINITOR TABLETS 2.5 MG ![Compare how all Medicare Part D PDP plans in CO cover AFINITOR TABLETS 2.5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in CO cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFREZZA 30-4 UNIT + 60-8 UNIT ![Compare how all Medicare Part D PDP plans in CO cover AFREZZA 30-4 UNIT + 60-8 UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AFREZZA 4 UNITS CARTRIDGE INH ![Compare how all Medicare Part D PDP plans in CO cover AFREZZA 4 UNITS CARTRIDGE INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AFREZZA 60-4 UNIT + 30-8 UNIT ![Compare how all Medicare Part D PDP plans in CO cover AFREZZA 60-4 UNIT + 30-8 UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AGRYLIN 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AGRYLIN 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AK-CON 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover AK-CON 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALA-CORT 1% CREAM ![Compare how all Medicare Part D PDP plans in CO cover ALA-CORT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALA-SCALP HP 2% LOTION ![Compare how all Medicare Part D PDP plans in CO cover ALA-SCALP HP 2% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALBENZA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALBENZA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL SULFATE SOLUTION FOR INHALATION ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE SOLUTION FOR INHALATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL SULFATE TABLET 2MG (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL SULFATE TABLET 2MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALBUTEROL TABLET 4MG (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover ALBUTEROL TABLET 4MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALCAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover ALCAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALCLOMETASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in CO cover ALCLOMETASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Alclometasone Dipropionate 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in CO cover Alclometasone Dipropionate 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALDACTAZIDE 25/25 TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALDACTAZIDE 25/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALDACTAZIDE 50/50 TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALDACTAZIDE 50/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALDACTONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALDACTONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALDACTONE 25MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALDACTONE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALDACTONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALDACTONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALDARA 5% CREAM ![Compare how all Medicare Part D PDP plans in CO cover ALDARA 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ALENDRONATE SODIUM 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALENDRONATE SODIUM 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
Alendronate Sodium 35mg/1 12 TABLET in 1 BOX, UNIT-DOSE ![Compare how all Medicare Part D PDP plans in CO cover Alendronate Sodium 35mg/1 12 TABLET in 1 BOX, UNIT-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | Q:4 /28Days |
ALENDRONATE SODIUM 40MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALENDRONATE SODIUM 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALENDRONATE SODIUM 5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALENDRONATE SODIUM 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
Alendronate Sodium 70 mg/75 ml ![Compare how all Medicare Part D PDP plans in CO cover Alendronate Sodium 70 mg/75 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Alendronate Sodium 70mg/1 4 BLISTER PACK in 1 BOX / 1 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Alendronate Sodium 70mg/1 4 BLISTER PACK in 1 BOX / 1 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | Q:4 /28Days |
ALFUZOSIN HYDROCHLORIDE 10mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ALFUZOSIN HYDROCHLORIDE 10mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALIMTA 500MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover ALIMTA 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALINIA 100MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in CO cover ALINIA 100MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALKERAN 50 MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover ALKERAN 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | P |
ALLOPURINOL 100 MG TABLETS ![Compare how all Medicare Part D PDP plans in CO cover ALLOPURINOL 100 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ALOCRIL 2% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover ALOCRIL 2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALOMIDE 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover ALOMIDE 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALOPRIM SOLUTION FOR INJECTION 500MG/VIAL 30 ML VIALGL ![Compare how all Medicare Part D PDP plans in CO cover ALOPRIM SOLUTION FOR INJECTION 500MG/VIAL 30 ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALORA 0.025 MG PATCH ![Compare how all Medicare Part D PDP plans in CO cover ALORA 0.025 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:8 /28Days |
ALORA 0.05 MG PATCH ![Compare how all Medicare Part D PDP plans in CO cover ALORA 0.05 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:8 /28Days |
ALORA 0.075 MG PATCH ![Compare how all Medicare Part D PDP plans in CO cover ALORA 0.075 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:8 /28Days |
ALORA 0.1 MG PATCH ![Compare how all Medicare Part D PDP plans in CO cover ALORA 0.1 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:8 /28Days |
ALOSETRON HCL 0.5 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in CO cover ALOSETRON HCL 0.5 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALOSETRON HCL 1 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in CO cover ALOSETRON HCL 1 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALOXI 0.25 MG/5 ML ![Compare how all Medicare Part D PDP plans in CO cover ALOXI 0.25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in CO cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALPHAGAN P 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover ALPHAGAN P 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALTACE 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ALTACE 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALTACE 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover ALTACE 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALTACE 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ALTACE 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALTACE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ALTACE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ALVESCO 160MCG/ACT AERS ![Compare how all Medicare Part D PDP plans in CO cover ALVESCO 160MCG/ACT AERS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ALVESCO 80MCG/ACT AERS ![Compare how all Medicare Part D PDP plans in CO cover ALVESCO 80MCG/ACT AERS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMANTADINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMANTADINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Amantadine Hydrochloride 50mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Amantadine Hydrochloride 50mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMARYL 1MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMARYL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AMARYL 2MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMARYL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AMARYL 4MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMARYL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMBIEN 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMBIEN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:30 /30Days |
AMBIEN TABLETS 5MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AMBIEN TABLETS 5MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:30 /30Days |
AMBISOME 50MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover AMBISOME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMCINONIDE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in CO cover AMCINONIDE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMCINONIDE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in CO cover AMCINONIDE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMCINONIDE 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in CO cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMERGE 1MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMERGE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:12 /30Days |
AMERGE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMERGE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:12 /30Days |
Amethia 2 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Amethia 2 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amethyst 20; 90ug/1; ug/1 1 BLISTER PACK per CARTON / 28 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Amethyst 20; 90ug/1; ug/1 1 BLISTER PACK per CARTON / 28 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMIFOSTINE 50mg/mL 3 VIAL, SINGLE-USE per CARTON / 10 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in CO cover AMIFOSTINE 50mg/mL 3 VIAL, SINGLE-USE per CARTON / 10 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMIKACIN SULFATE 500 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover AMIKACIN SULFATE 500 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMILORIDE HCL W/HCTZ 5MG-50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMILORIDE HCL W/HCTZ 5MG-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in CO cover AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Aminophylline 25mg/mL 5 TRAY per CARTON / 5 AMPULE in 1 TRAY / 10 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in CO cover Aminophylline 25mg/mL 5 TRAY per CARTON / 5 AMPULE in 1 TRAY / 10 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMINOSYN 7%-ELECTROLYTE SOL ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN 7%-ELECTROLYTE SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMINOSYN HBC INJECTION SULFITE FREE 7% ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN HBC INJECTION SULFITE FREE 7%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN II 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN II 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | P |
AMINOSYN II 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN II 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN II 8.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN II 8.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN M 3.5% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN M 3.5% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AMINOSYN-RF 5.2% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AMINOSYN-RF 5.2% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMIODARONE HCL 200MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AMIODARONE HCL 200MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMIODARONE HCL 400MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMIODARONE HCL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMIODARONE HCL 50 MG INJECTION ![Compare how all Medicare Part D PDP plans in CO cover AMIODARONE HCL 50 MG INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in CO cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIP/PERPHEN 10-2 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIP/PERPHEN 10-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITRIP/PERPHEN 25-2 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIP/PERPHEN 25-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITRIP/PERPHEN 25-4 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIP/PERPHEN 25-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMITRIPTYLINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIPTYLINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMITRIPTYLINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMITRIPTYLINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMITRIPTYLINE HCL 150 MG TAB ![Compare how all Medicare Part D PDP plans in CO cover AMITRIPTYLINE HCL 150 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMITRIPTYLINE HCL 25MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover AMITRIPTYLINE HCL 25MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMITRIPTYLINE HCL 75MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover AMITRIPTYLINE HCL 75MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMITRIPTYLINE HCL TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in CO cover AMITRIPTYLINE HCL TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE BESYLATE 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE 2.5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE BESYLATE 5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE 5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 10-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 10-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 10-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 10-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 10-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 10-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 10-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 10-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amlodipine-Atorvastatin 2.5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 2.5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 2.5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 2.5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 2.5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 2.5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amlodipine-Atorvastatin 5-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in CO cover Amlodipine-Atorvastatin 5-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE-BENAZEPRIL 10-40 MG ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE-BENAZEPRIL 10-40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMLODIPINE-BENAZEPRIL 5-40 MG ![Compare how all Medicare Part D PDP plans in CO cover AMLODIPINE-BENAZEPRIL 5-40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMMONIUM CHLORIDE 5 MEQ/ML ![Compare how all Medicare Part D PDP plans in CO cover AMMONIUM CHLORIDE 5 MEQ/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ammonium lactate 12% cream ![Compare how all Medicare Part D PDP plans in CO cover ammonium lactate 12% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in CO cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Amnesteem 10mg/1 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Amnesteem 10mg/1 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Amnesteem 20mg/1 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Amnesteem 20mg/1 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Amnesteem 40mg/1 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Amnesteem 40mg/1 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
amox tr-k clv 200-28.5/5 susp ![Compare how all Medicare Part D PDP plans in CO cover amox tr-k clv 200-28.5/5 susp.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOX TR-K CLV 500-125 MG TAB ![Compare how all Medicare Part D PDP plans in CO cover AMOX TR-K CLV 500-125 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in CO cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in CO cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in CO cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN 250MG 500 CHEWABLE TABLET in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 250MG 500 CHEWABLE TABLET in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN 50 MG/ML / CLAVULANATE 12.5 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 50 MG/ML / CLAVULANATE 12.5 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN 500MG 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 500MG 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS EXTENDED RELEASE 1000;62.5MG;MG ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS EXTENDED RELEASE 1000;62.5MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL ![Compare how all Medicare Part D PDP plans in CO cover AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPHETAMINE SALT COMBO 30MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMPHETAMINE SALT COMBO 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPHETAMINE SALTS 20MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AMPHETAMINE SALTS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALTS 5 MG TAB ![Compare how all Medicare Part D PDP plans in CO cover AMPHETAMINE SALTS 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in CO cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPICILLIN CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPICILLIN FOR INJECTION POWDER ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN FOR INJECTION POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AMPICILLIN POWDER FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN POWDER FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPICILLIN-SULBACTAM 15 GM VIAL ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN-SULBACTAM 15 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AMPICILLIN-SULBACTAM 3 GM VIAL ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN-SULBACTAM 3 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPICILLIN-SULBACTAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in CO cover AMPICILLIN-SULBACTAM FOR INJECTION .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ANAFRANIL 25 MG 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ANAFRANIL 25 MG 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANAFRANIL 50 MG 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ANAFRANIL 50 MG 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANAFRANIL 75 MG 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ANAFRANIL 75 MG 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ANAPROX 275MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANAPROX 275MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANAPROX DS 550MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANAPROX DS 550MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Anastrozole 1mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in CO cover Anastrozole 1mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ANCOBON 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ANCOBON 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ANCOBON 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ANCOBON 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANDRODERM 2 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in CO cover ANDRODERM 2 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:30 /30Days |
ANDRODERM 4 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in CO cover ANDRODERM 4 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:30 /30Days |
ANDROGEL 1.62% (1.25G) GEL PCKT ![Compare how all Medicare Part D PDP plans in CO cover ANDROGEL 1.62% (1.25G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANDROGEL 1.62% (2.5G) GEL PCKT ![Compare how all Medicare Part D PDP plans in CO cover ANDROGEL 1.62% (2.5G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANDROGEL 1% (50MG) GEL PACKET ![Compare how all Medicare Part D PDP plans in CO cover ANDROGEL 1% (50MG) GEL PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:300 /30Days |
Androgel 10mg/g 2 BOTTLE, PUMP in 1 CARTON / 75 g in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in CO cover Androgel 10mg/g 2 BOTTLE, PUMP in 1 CARTON / 75 g in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:300 /30Days |
Androgel 10mg/g 30 PACKET in 1 CARTON / 2.5 g in 1 PACKET ![Compare how all Medicare Part D PDP plans in CO cover Androgel 10mg/g 30 PACKET in 1 CARTON / 2.5 g in 1 PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:300 /30Days |
Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in CO cover Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANDROID 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ANDROID 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANDROID 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ANDROID 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANGELIQ 0.25 MG-0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANGELIQ 0.25 MG-0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANGELIQ 1-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANGELIQ 1-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in CO cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANTABUSE 250MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANTABUSE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANTABUSE 500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANTABUSE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANTARA 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ANTARA 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANTARA 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ANTARA 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANUSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in CO cover ANUSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ANZEMET 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANZEMET 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ANZEMET 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ANZEMET 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ANZEMET 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ANZEMET 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
Apexicon E 0.05% Cream ![Compare how all Medicare Part D PDP plans in CO cover Apexicon E 0.05% Cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APIDRA 100 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover APIDRA 100 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
APIDRA SOLOSTAR 100 UNITS/ML ![Compare how all Medicare Part D PDP plans in CO cover APIDRA SOLOSTAR 100 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in CO cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER per CARTON / 10 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in CO cover Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER per CARTON / 10 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in CO cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
APRISO CP24 ![Compare how all Medicare Part D PDP plans in CO cover APRISO CP24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in CO cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ARALAST NP 500 MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARALAST NP 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARANESP 10 MCG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 10 MCG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 100ug/0.5mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 100ug/0.5mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 200MCG/0.4ML SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 200MCG/0.4ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 200MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 200MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 25ug/0.42mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.42 mL in 1 SYRING ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 25ug/0.42mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.42 mL in 1 SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 25ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 25ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP 500MCG/1ML SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 500MCG/1ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 60MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 60MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP 60ug/0.3mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.3 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARANESP 60ug/0.3mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.3 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR ![Compare how all Medicare Part D PDP plans in CO cover ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR ![Compare how all Medicare Part D PDP plans in CO cover ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR ![Compare how all Medicare Part D PDP plans in CO cover ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD ![Compare how all Medicare Part D PDP plans in CO cover ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ARAVA 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARAVA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARAVA 20MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARAVA 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARBINOXA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARBINOXA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARBINOXA 4 MG/5 ML LIQUID ![Compare how all Medicare Part D PDP plans in CO cover ARBINOXA 4 MG/5 ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Arcapta Neohaler 75ug/1 30 BLISTER PACK in 1 BOX / 1 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CO cover Arcapta Neohaler 75ug/1 30 BLISTER PACK in 1 BOX / 1 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:30 /30Days |
ARGATROBAN 100mg/mL 1 VIAL per CARTON / 2.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARGATROBAN 100mg/mL 1 VIAL per CARTON / 2.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Argatroban 125mg/125mL 2 VIAL, SINGLE-USE per CARTON / 125 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in CO cover Argatroban 125mg/125mL 2 VIAL, SINGLE-USE per CARTON / 125 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ARICEPT 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARICEPT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARICEPT 5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARICEPT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARIMIDEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ARIMIDEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in CO cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in CO cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in CO cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in CO cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in CO cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in CO cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ARIXTRA 10MG SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARIXTRA 10MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARIXTRA 2.5 MG SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARIXTRA 2.5 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARIXTRA 5MG SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARIXTRA 5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARIXTRA 7.5MG SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ARIXTRA 7.5MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARNUITY ELLIPTA 100 MCG INH ![Compare how all Medicare Part D PDP plans in CO cover ARNUITY ELLIPTA 100 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:30 /30Days |
ARNUITY ELLIPTA 200 MCG INH ![Compare how all Medicare Part D PDP plans in CO cover ARNUITY ELLIPTA 200 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:30 /30Days |
AROMASIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AROMASIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARRANON 250MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARRANON 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ARTHROTEC 50 50MG TABLET -200MCG (60 CT) ![Compare how all Medicare Part D PDP plans in CO cover ARTHROTEC 50 50MG TABLET -200MCG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARTHROTEC 75 TABLET EC ![Compare how all Medicare Part D PDP plans in CO cover ARTHROTEC 75 TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ARZERRA 20mg/mL 3 VIAL per CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover ARZERRA 20mg/mL 3 VIAL per CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ASACOL HD 800mg/1 12 BOTTLE CASE / 180 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ASACOL HD 800mg/1 12 BOTTLE CASE / 180 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ASCOMP WITH CODEINE CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ASCOMP WITH CODEINE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Ashlyna 0.15-0.03-0.01 mg tablet ![Compare how all Medicare Part D PDP plans in CO cover Ashlyna 0.15-0.03-0.01 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ASMANEX HFA 100 MCG INHALER ![Compare how all Medicare Part D PDP plans in CO cover ASMANEX HFA 100 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:13 /30Days |
ASMANEX HFA 200 MCG INHALER ![Compare how all Medicare Part D PDP plans in CO cover ASMANEX HFA 200 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:13 /30Days |
ASMANEX TWISTHALER 110 MCG #30 ![Compare how all Medicare Part D PDP plans in CO cover ASMANEX TWISTHALER 110 MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | Q:1 /30Days |
ASMANEX TWISTHALER 220 MCG #30 ![Compare how all Medicare Part D PDP plans in CO cover ASMANEX TWISTHALER 220 MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | Q:2 /30Days |
ASMANEX TWISTHALER 220MCG #120 ![Compare how all Medicare Part D PDP plans in CO cover ASMANEX TWISTHALER 220MCG #120.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | Q:2 /30Days |
ASMANEX TWISTHALER 220MCG #60 ![Compare how all Medicare Part D PDP plans in CO cover ASMANEX TWISTHALER 220MCG #60.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | Q:2 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE ![Compare how all Medicare Part D PDP plans in CO cover ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ASTAGRAF XL 0.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ASTAGRAF XL 0.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ASTAGRAF XL 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ASTAGRAF XL 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ASTAGRAF XL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover ASTAGRAF XL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
ASTEPRO 0.15% NASAL SPRAY 30 ML ![Compare how all Medicare Part D PDP plans in CO cover ASTEPRO 0.15% NASAL SPRAY 30 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATACAND 16MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ATACAND 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATACAND 32MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ATACAND 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATACAND 4MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ATACAND 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATACAND 8MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ATACAND 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATACAND HCT 16/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ATACAND HCT 16/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATACAND HCT 32/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover ATACAND HCT 32/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATACAND HCT TABLETS 32;25MG;MG 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ATACAND HCT TABLETS 32;25MG;MG 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATENOLOL 100 MG100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ATENOLOL 100 MG100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
ATENOLOL 25 MG 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover ATENOLOL 25 MG 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
ATENOLOL TABLET USP 50MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover ATENOLOL TABLET USP 50MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in CO cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$3.00 | $7.50 | None |
ATGAM 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in CO cover ATGAM 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in CO cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in CO cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in CO cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in CO cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in CO cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in CO cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Atovaquone-Proguanil 62.5-25 [Malarone] ![Compare how all Medicare Part D PDP plans in CO cover Atovaquone-Proguanil 62.5-25 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in CO cover Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ATROPINE 0.05MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ATROPINE 0.05MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
ATROPINE 0.1MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in CO cover ATROPINE 0.1MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Atropine 1% Eye Drops ![Compare how all Medicare Part D PDP plans in CO cover Atropine 1% Eye Drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in CO cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | Q:26 /30Days |
ATROVENT NASAL SPRAY 0.03% ![Compare how all Medicare Part D PDP plans in CO cover ATROVENT NASAL SPRAY 0.03%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
ATROVENT NASAL SPRAY 0.06% ![Compare how all Medicare Part D PDP plans in CO cover ATROVENT NASAL SPRAY 0.06%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AUBRA-28 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AUBRA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AUGMENTED BETAMETHASONE DIPROPIONATE OINTMENT ![Compare how all Medicare Part D PDP plans in CO cover AUGMENTED BETAMETHASONE DIPROPIONATE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AUGMENTIN 125; 31.25mg/5mL; mg/5mL 100 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AUGMENTIN 125; 31.25mg/5mL; mg/5mL 100 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AUVI-Q 0.15 MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in CO cover AUVI-Q 0.15 MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AUVI-Q 0.3 MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in CO cover AUVI-Q 0.3 MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AVALIDE 150-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVALIDE 150-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVALIDE 300-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVALIDE 300-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVANDAMET 1000; 2mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AVANDAMET 1000; 2mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVANDIA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVANDIA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVANDIA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVANDIA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVANDIA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVANDIA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVAPRO 150 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVAPRO 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVAPRO 300 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVAPRO 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVAPRO 75 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVAPRO 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AVELOX 400MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVELOX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVELOX ABC PACK 400MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVELOX ABC PACK 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVELOX IV 400MG/250ML ![Compare how all Medicare Part D PDP plans in CO cover AVELOX IV 400MG/250ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in CO cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AVINZA CAPSULES ER 75MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover AVINZA CAPSULES ER 75MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:48 /30Days |
AVITA 0.025% CREAM ![Compare how all Medicare Part D PDP plans in CO cover AVITA 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
Avita 0.25mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in CO cover Avita 0.25mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
AVODART 0.5MG SOFTGEL ![Compare how all Medicare Part D PDP plans in CO cover AVODART 0.5MG SOFTGEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVONEX ADMIN PACK 30MCG SYR ![Compare how all Medicare Part D PDP plans in CO cover AVONEX ADMIN PACK 30MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
AVONEX ADMIN PACK 30MCG VL ![Compare how all Medicare Part D PDP plans in CO cover AVONEX ADMIN PACK 30MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
AVONEX PEN 30 MCG/0.5 ML KIT ![Compare how all Medicare Part D PDP plans in CO cover AVONEX PEN 30 MCG/0.5 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
AXERT 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AXERT 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:12 /30Days |
AXERT 6.25 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AXERT 6.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:12 /30Days |
AXIRON 30mg/1.5mL 1 BOTTLE, WITH APPLICATOR per CARTON / 90 mL in 1 BOTTLE, WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in CO cover AXIRON 30mg/1.5mL 1 BOTTLE, WITH APPLICATOR per CARTON / 90 mL in 1 BOTTLE, WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Aygestin 5mg/1 50 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Aygestin 5mg/1 50 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
Azacitidine 100 mg vial [Vidaza] ![Compare how all Medicare Part D PDP plans in CO cover Azacitidine 100 mg vial [Vidaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZACTAM 1g/1 10 VIAL, SINGLE-DOSE in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE ![Compare how all Medicare Part D PDP plans in CO cover AZACTAM 1g/1 10 VIAL, SINGLE-DOSE in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, SINGLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AZACTAM INJECTION 1GM/50ML ![Compare how all Medicare Part D PDP plans in CO cover AZACTAM INJECTION 1GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZACTAM INJECTION 2GM/50ML ![Compare how all Medicare Part D PDP plans in CO cover AZACTAM INJECTION 2GM/50ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZASAN 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZASAN 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AZASAN 75MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZASAN 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | P |
AZASITE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover AZASITE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZATHIOPRINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZATHIOPRINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
AZELASTINE 0.15% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in CO cover AZELASTINE 0.15% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in CO cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | Q:60 /30Days |
AZELASTINE HYDROCHLORIDE OPHTHALMIC SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover AZELASTINE HYDROCHLORIDE OPHTHALMIC SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AZELEX 20% CREAM 30GM TUBE ![Compare how all Medicare Part D PDP plans in CO cover AZELEX 20% CREAM 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZILECT 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZILECT 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZILECT 1MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZILECT 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$45.00 | $112.50 | None |
AZITHROMYCIN 1 GM PWD PACKET ![Compare how all Medicare Part D PDP plans in CO cover AZITHROMYCIN 1 GM PWD PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Azithromycin 100mg/5mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Azithromycin 100mg/5mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Azithromycin 200mg/5mL 22.5 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Azithromycin 200mg/5mL 22.5 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Azithromycin 500mg/1 10 VIAL, SINGLE-USE in 1 TRAY / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover Azithromycin 500mg/1 10 VIAL, SINGLE-USE in 1 TRAY / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Azithromycin 600mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in CO cover Azithromycin 600mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in CO cover AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | Q:15 /30Days |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in CO cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
AZULFIDINE 500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover AZULFIDINE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |
AZULFIDINE EN TABLET S 500MG TABLET 6 X (300 CT)PL ![Compare how all Medicare Part D PDP plans in CO cover AZULFIDINE EN TABLET S 500MG TABLET 6 X (300 CT)PL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $187.50 | None |