2015 Medicare Part D Plan Formulary Information |
PriorityMedicare (HMO-POS) (H2320-013-0)
Benefit Details
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The PriorityMedicare (HMO-POS) (H2320-013-0) Formulary Drugs Starting with the Letter B in OTTAWA County, MI: CMS MA Region 11 which includes: MI Plan Monthly Premium: $95.00 Deductible: $0 |
Drugs Starting with Letter B
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Bacitracin 500 unit/gm Eye Ointment ![Compare how all Medicare Part D PDP plans in MI cover Bacitracin 500 unit/gm Eye Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT ![Compare how all Medicare Part D PDP plans in MI cover BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BACLOFEN 10MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BACLOFEN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BACLOFEN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BACLOFEN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BACTROBAN NASAL 2% OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover BACTROBAN NASAL 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT) ![Compare how all Medicare Part D PDP plans in MI cover BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Balziva 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MI cover Balziva 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Banzel 200mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Banzel 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | P |
Banzel 40mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Banzel 40mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | P |
BANZEL TABLET 400MG ![Compare how all Medicare Part D PDP plans in MI cover BANZEL TABLET 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:600 /30Days |
BARACLUDE 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BARACLUDE 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
BARACLUDE 1MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BARACLUDE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
BECONASE AQ 0.042% SPRAY ![Compare how all Medicare Part D PDP plans in MI cover BECONASE AQ 0.042% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
BELEODAQ 500 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover BELEODAQ 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
BENAZEPRIL HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
BENAZEPRIL HCL 20mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL 20mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
BENAZEPRIL HCL 40MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
BENAZEPRIL HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BENLYSTA 120mg/1.5mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MI cover BENLYSTA 120mg/1.5mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Betamethasone Dipropionate 0.5mg/g 1 TUBE in 1 CARTON / 50 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MI cover Betamethasone Dipropionate 0.5mg/g 1 TUBE in 1 CARTON / 50 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Betamethasone Dipropionate 0.60mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Betamethasone Dipropionate 0.60mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Betamethasone Dipropionate 0.64mg/g / 45 g TUBE ![Compare how all Medicare Part D PDP plans in MI cover Betamethasone Dipropionate 0.64mg/g / 45 g TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Betamethasone Dipropionate 0.64mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Betamethasone Dipropionate 0.64mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Betamethasone DP 0.05% ointment ![Compare how all Medicare Part D PDP plans in MI cover Betamethasone DP 0.05% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETAMETHASONE DP AUG 0.05% GEL ![Compare how all Medicare Part D PDP plans in MI cover BETAMETHASONE DP AUG 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETAMETHASONE VALERATE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in MI cover BETAMETHASONE VALERATE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETAMETHASONE VALERATE 0.12% FOAM ![Compare how all Medicare Part D PDP plans in MI cover BETAMETHASONE VALERATE 0.12% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAMETHASONE VALERATE CREAM ![Compare how all Medicare Part D PDP plans in MI cover BETAMETHASONE VALERATE CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETAMETHASONE VALERATE OINTMENT USP ![Compare how all Medicare Part D PDP plans in MI cover BETAMETHASONE VALERATE OINTMENT USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM ![Compare how all Medicare Part D PDP plans in MI cover BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | S |
Betaxolol 10mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Betaxolol 10mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Betaxolol 20mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Betaxolol 20mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Betaxolol hcl 0.5% eye drop ![Compare how all Medicare Part D PDP plans in MI cover Betaxolol hcl 0.5% eye drop.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETHANECHOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BETHANECHOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETHANECHOL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BETHANECHOL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETHANECHOL CHLORIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BETHANECHOL CHLORIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETHANECHOL CHLORIDE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BETHANECHOL CHLORIDE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BETHKIS 300 MG/4 ML AMPULE ![Compare how all Medicare Part D PDP plans in MI cover BETHKIS 300 MG/4 ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETIMOL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover BETIMOL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BETOPTIC S OPHTHALMIC SUSPENSION 0.25% 10 ML BOT ![Compare how all Medicare Part D PDP plans in MI cover BETOPTIC S OPHTHALMIC SUSPENSION 0.25% 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Beyaz 3 BLISTER PACK in 1 PACKAGE / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MI cover Beyaz 3 BLISTER PACK in 1 PACKAGE / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Bicalutamide 50mL/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Bicalutamide 50mL/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BICILL LA PFS 600MU 1ML PED ![Compare how all Medicare Part D PDP plans in MI cover BICILL LA PFS 600MU 1ML PED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BICILLIN C-R 1.2MM UNITS SYR 2ML x 10 ![Compare how all Medicare Part D PDP plans in MI cover BICILLIN C-R 1.2MM UNITS SYR 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BICILLIN C-R 900/300 SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in MI cover BICILLIN C-R 900/300 SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BICILLIN LA PFS 1200MU 2ML ![Compare how all Medicare Part D PDP plans in MI cover BICILLIN LA PFS 1200MU 2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BICILLIN LA. 600000UNIT/ML 1ML ![Compare how all Medicare Part D PDP plans in MI cover BICILLIN LA. 600000UNIT/ML 1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BICNU 100 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover BICNU 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
BIDIL TABLET ![Compare how all Medicare Part D PDP plans in MI cover BIDIL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Biltricide 600mg/1 6 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Biltricide 600mg/1 6 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BIMATOPROST 0.03% EYE DROPS [Lumigan] ![Compare how all Medicare Part D PDP plans in MI cover BIMATOPROST 0.03% EYE DROPS [Lumigan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BINOSTO 70 MG TABLET EFF ![Compare how all Medicare Part D PDP plans in MI cover BINOSTO 70 MG TABLET EFF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:4 /28Days |
BISOPROLOL FUMARATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BISOPROLOL FUMARATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BISOPROLOL FUMARATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BISOPROLOL FUMARATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BLEOMYCIN SULFATE 30UNITS VIA ![Compare how all Medicare Part D PDP plans in MI cover BLEOMYCIN SULFATE 30UNITS VIA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BLEPHAMIDE 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover BLEPHAMIDE 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
BLEPHAMIDE 10-0.2% EYE OINT ![Compare how all Medicare Part D PDP plans in MI cover BLEPHAMIDE 10-0.2% EYE OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BONIVA 3mg/3mL SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover BONIVA 3mg/3mL SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
BOOSTRIX TDAP VACCINE SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover BOOSTRIX TDAP VACCINE SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BOOSTRIX TDAP VACCINE VIAL ![Compare how all Medicare Part D PDP plans in MI cover BOOSTRIX TDAP VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
BOSULIF 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BOSULIF 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
BOSULIF 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BOSULIF 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
BREO ELLIPTA 100-25 MCG INH ![Compare how all Medicare Part D PDP plans in MI cover BREO ELLIPTA 100-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:60 /30Days |
BREO ELLIPTA 200-25 MCG INH ![Compare how all Medicare Part D PDP plans in MI cover BREO ELLIPTA 200-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:60 /30Days |
BRILINTA 90mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover BRILINTA 90mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:60 /30Days |
Brimonidine Tartrate 1.5mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Brimonidine Tartrate 1.5mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL ![Compare how all Medicare Part D PDP plans in MI cover BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BRINTELLIX 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BRINTELLIX 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BRINTELLIX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BRINTELLIX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:30 /30Days |
BRINTELLIX 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BRINTELLIX 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:30 /30Days |
BRISDELLE 7.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover BRISDELLE 7.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:30 /30Days |
Bromfenac 1.035mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in MI cover Bromfenac 1.035mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Bromocriptine mesylate 2.5mg/1 24 BOTTLE per CARTON / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bromocriptine mesylate 2.5mg/1 24 BOTTLE per CARTON / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BROMOCRIPTINE MESYLATE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover BROMOCRIPTINE MESYLATE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BROVANA 15MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in MI cover BROVANA 15MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | P |
BUDESONIDE 0.25 MG/2 ML SUSP ![Compare how all Medicare Part D PDP plans in MI cover BUDESONIDE 0.25 MG/2 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | P |
BUDESONIDE 0.5 MG/2 ML SUSP ![Compare how all Medicare Part D PDP plans in MI cover BUDESONIDE 0.5 MG/2 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | P |
Budesonide 32 mcg nasal spray ![Compare how all Medicare Part D PDP plans in MI cover Budesonide 32 mcg nasal spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Budesonide 3mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Budesonide 3mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Bumetanide 0.5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bumetanide 0.5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Bumetanide 1mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in MI cover Bumetanide 1mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Bumetanide 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bumetanide 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
buprenorphin-naloxon 2-0.5 mg tb ![Compare how all Medicare Part D PDP plans in MI cover buprenorphin-naloxon 2-0.5 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | P Q:90 /30Days |
buprenorphin-naloxon 8-2 mg tb ![Compare how all Medicare Part D PDP plans in MI cover buprenorphin-naloxon 8-2 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | P Q:90 /30Days |
BUPRENORPHINE 0.3MG/ML SYRN ![Compare how all Medicare Part D PDP plans in MI cover BUPRENORPHINE 0.3MG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Buprenorphine HCl 2mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Buprenorphine HCl 2mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | Q:120 /30Days |
Buprenorphine HCl 8mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Buprenorphine HCl 8mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | Q:60 /30Days |
BUPROBAN ER 150 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BUPROBAN ER 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUPROPION HCL SR 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BUPROPION HCL SR 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUPROPION HCL SR 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover BUPROPION HCL SR 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPROPION HCL XL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BUPROPION HCL XL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUPROPION HCL XL 300 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BUPROPION HCL XL 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Bupropion Hydrochloride 100mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bupropion Hydrochloride 100mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Bupropion Hydrochloride 150mg/1 100 TABLET, ER in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bupropion Hydrochloride 150mg/1 100 TABLET, ER in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUPROPION HYDROCHLORIDE 75mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover BUPROPION HYDROCHLORIDE 75mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUSPIRONE HCL 15MG TABLET (180 CT) ![Compare how all Medicare Part D PDP plans in MI cover BUSPIRONE HCL 15MG TABLET (180 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUSPIRONE HCL 30MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in MI cover BUSPIRONE HCL 30MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUSPIRONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BUSPIRONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUSPIRONE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BUSPIRONE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUSPIRONE HYDROCHLORIDE 10 MG TABLETS ![Compare how all Medicare Part D PDP plans in MI cover BUSPIRONE HYDROCHLORIDE 10 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUSULFEX 6mg/mL ![Compare how all Medicare Part D PDP plans in MI cover BUSULFEX 6mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Butorphanol 1 mg/ml vial ![Compare how all Medicare Part D PDP plans in MI cover Butorphanol 1 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
BUTORPHANOL 10MG/ML SPRAY ![Compare how all Medicare Part D PDP plans in MI cover BUTORPHANOL 10MG/ML SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Butorphanol 2 mg/ml vial ![Compare how all Medicare Part D PDP plans in MI cover Butorphanol 2 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None |
Butrans 10ug/h ![Compare how all Medicare Part D PDP plans in MI cover Butrans 10ug/h.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:4 /28Days |
BUTRANS 15 MCG/HR PATCH ![Compare how all Medicare Part D PDP plans in MI cover BUTRANS 15 MCG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:4 /28Days |
Butrans 20ug/h ![Compare how all Medicare Part D PDP plans in MI cover Butrans 20ug/h.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:4 /28Days |
Butrans 5ug/h ![Compare how all Medicare Part D PDP plans in MI cover Butrans 5ug/h.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:4 /28Days |
BUTRANS 7.5 MCG/HR PATCH ![Compare how all Medicare Part D PDP plans in MI cover BUTRANS 7.5 MCG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:4 /28Days |
BYDUREON 2 MG PEN INJECT ![Compare how all Medicare Part D PDP plans in MI cover BYDUREON 2 MG PEN INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:4 /28Days |
BYDUREON 2 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover BYDUREON 2 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:4 /28Days |
BYETTA 10 MCG DOSE PEN INJ ![Compare how all Medicare Part D PDP plans in MI cover BYETTA 10 MCG DOSE PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BYETTA 5 MCG DOSE PEN INJ ![Compare how all Medicare Part D PDP plans in MI cover BYETTA 5 MCG DOSE PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Bystolic 10mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bystolic 10mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Bystolic 2.5mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bystolic 2.5mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
BYSTOLIC 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover BYSTOLIC 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Bystolic 5mg 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Bystolic 5mg 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |