2015 Medicare Part D Plan Formulary Information |
Patriot Plus (PFFS) (H3421-002-0)
Benefit Details
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The Patriot Plus (PFFS) (H3421-002-0) Formulary Drugs Starting with the Letter E in RICHLAND County, SC: CMS MA Region 8 which includes: SC Plan Monthly Premium: $58.00 Deductible: $0 |
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in SC cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in SC cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
EFFIENT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EFFIENT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
EFFIENT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EFFIENT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
EGRIFTA 1 MG VIAL ![Compare how all Medicare Part D PDP plans in SC cover EGRIFTA 1 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | None |
ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in SC cover ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ELELYSO 200 UNITS VIAL ![Compare how all Medicare Part D PDP plans in SC cover ELELYSO 200 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ELIDEL 1% CREAM ![Compare how all Medicare Part D PDP plans in SC cover ELIDEL 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | S |
ELIGARD 22.5 MG SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ELIGARD 22.5 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ELIGARD 7.5 MG SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ELIGARD 7.5 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Elitek 3 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in SC cover Elitek 3 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ELIXOPHYLLIN 80mg/15mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover ELIXOPHYLLIN 80mg/15mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ELLA 30 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ELLA 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ELLENCE 2MG/ML VIAL ![Compare how all Medicare Part D PDP plans in SC cover ELLENCE 2MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ELOXATIN 100MG/20ML VIAL ![Compare how all Medicare Part D PDP plans in SC cover ELOXATIN 100MG/20ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
EMEND CAPSULES 125MG 6 BLPK ![Compare how all Medicare Part D PDP plans in SC cover EMEND CAPSULES 125MG 6 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:4 /30Days |
EMEND CAPSULES 80MG 2 BLPK ![Compare how all Medicare Part D PDP plans in SC cover EMEND CAPSULES 80MG 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:8 /30Days |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in SC cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:12 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in SC cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in SC cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in SC cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
Enablex 15mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Enablex 15mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Enablex 7.5mg EXTENDED RELEASE 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Enablex 7.5mg EXTENDED RELEASE 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ENALAPRIL MALEATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in SC cover Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in SC cover Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ENBREL 50 MG/ML SURECLICK SYR ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 50 MG/ML SURECLICK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ENBREL 50mg/mL ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | Q:360 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in SC cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in SC cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
ENGERIX-B 20 MCG/ML SYRN ![Compare how all Medicare Part D PDP plans in SC cover ENGERIX-B 20 MCG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
ENJUVIA 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENJUVIA 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
ENJUVIA 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENJUVIA 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
ENJUVIA 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENJUVIA 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENJUVIA 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENJUVIA 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
ENJUVIA 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENJUVIA 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P Q:30 /30Days |
ENOXAPARIN 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 120 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 120 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 150 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 150 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 30 MG/0.3 ML SYR ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 30 MG/0.3 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 300 MG/3 ML VIAL ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 300 MG/3 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 40 MG/0.4 ML SYR ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 40 MG/0.4 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 60 MG/0.6 ML SYR ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 60 MG/0.6 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENOXAPARIN 80 MG/0.8 ML SYR ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 80 MG/0.8 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:28 /14Days |
ENTACAPONE 200 MG TABLET [Comtan Entacapone] ![Compare how all Medicare Part D PDP plans in SC cover ENTACAPONE 200 MG TABLET [Comtan Entacapone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENTOCORT EC 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover ENTOCORT EC 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | None |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
EPINASTINE HCL 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in SC cover EPINASTINE HCL 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in SC cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | Q:2 /30Days |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in SC cover EPIPEN JR 0.15MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | Q:2 /30Days |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
EPIVIR 10 MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover EPIVIR 10 MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
EPIVIR 150 MG TABLETS ![Compare how all Medicare Part D PDP plans in SC cover EPIVIR 150 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
EPIVIR 300mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover EPIVIR 300mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
EPIVIR HBV 100MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EPIVIR HBV 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in SC cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Eplerenone 25mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Eplerenone 25mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
Eplerenone 50mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Eplerenone 50mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in SC cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in SC cover EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in SC cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in SC cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
EPZICOM 600MG/300MG TABLETS ![Compare how all Medicare Part D PDP plans in SC cover EPZICOM 600MG/300MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | None |
ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in SC cover ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in SC cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ERGOLOID MESYLATES TABLETS 1MG 100 BOT ![Compare how all Medicare Part D PDP plans in SC cover ERGOLOID MESYLATES TABLETS 1MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | P |
ERGOMAR 2 MG TABLET SL ![Compare how all Medicare Part D PDP plans in SC cover ERGOMAR 2 MG TABLET SL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
ERRIN 0.35MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ERRIN 0.35MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ERWINAZE 10,000 UNITS VIAL ![Compare how all Medicare Part D PDP plans in SC cover ERWINAZE 10,000 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | P |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in SC cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERY-TAB TAB 250MG EC ![Compare how all Medicare Part D PDP plans in SC cover ERY-TAB TAB 250MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERY-TAB TAB 333MG EC ![Compare how all Medicare Part D PDP plans in SC cover ERY-TAB TAB 333MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERYPED 200 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in SC cover ERYPED 200 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERYPED 400 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in SC cover ERYPED 400 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ERYTHROCIN TAB 250MG ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROCIN TAB 250MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Erythromycin 2% solution ![Compare how all Medicare Part D PDP plans in SC cover Erythromycin 2% solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in SC cover Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ERYTHROMYCIN 500 MG FILMTAB ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN 500 MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERYTHROMYCIN ES 400 MG TAB ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN ES 400 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ERYTHROMYCIN TAB 250MG BS ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN TAB 250MG BS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | Q:30 /30Days |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | Q:30 /30Days |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | Q:30 /30Days |
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | Q:600 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Estazolam 1mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Estazolam 1mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | P |
Estazolam 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Estazolam 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | P |
ESTRACE VAG CREAM 0.1MG/GM ![Compare how all Medicare Part D PDP plans in SC cover ESTRACE VAG CREAM 0.1MG/GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | P |
ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | P |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in SC cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6 ![Compare how all Medicare Part D PDP plans in SC cover ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ethosuximide 250mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Ethosuximide 250mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in SC cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
Etodolac 300 mg capsule ![Compare how all Medicare Part D PDP plans in SC cover Etodolac 300 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
ETODOLAC 400 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Etodolac 500mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Etodolac 500mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $10.00 | None |
Evista 60mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover Evista 60mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | Q:30 /30Days |
EVOTAZ 300 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EVOTAZ 300 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EVOXAC 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EVOXAC 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$45.00 | $112.50 | None |
EXELON 1.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EXELON 1.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:90 /30Days |
EXELON 13.3 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in SC cover EXELON 13.3 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:30 /30Days |
EXELON 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EXELON 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:60 /30Days |
EXELON 4.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EXELON 4.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:60 /30Days |
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in SC cover EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:30 /30Days |
EXELON 6MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EXELON 6MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:60 /30Days |
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS ![Compare how all Medicare Part D PDP plans in SC cover EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | Q:30 /30Days |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | None |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | 33% | None |