2015 Medicare Part D Plan Formulary Information |
Geisinger Gold Secure Rx (HMO SNP) (H3954-097-0)
Benefit Details
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The Geisinger Gold Secure Rx (HMO SNP) (H3954-097-0) Formulary Drugs Starting with the Letter F in BLAIR County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $33.90 Deductible: $320 |
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FABIOR 0.1% FOAM ![Compare how all Medicare Part D PDP plans in PA cover FABIOR 0.1% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FABRAZYME 35MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FABRAZYME 35MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FALMINA-28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover FALMINA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMCICLOVIR 125MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMCICLOVIR 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMCICLOVIR 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMOTIDINE 20MG PIGGYBACK ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 20MG PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMOTIDINE 20MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 20MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMOTIDINE 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 1 KIT in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 1 KIT in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 1 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 1 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 10 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 10 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 12 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 12 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 2 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 2 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 4 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 4 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 6 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 6 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FANAPT 8 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 8 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FARESTON 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FARESTON 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FARYDAK 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FARYDAK 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:6 /21Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FARYDAK 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FARYDAK 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:6 /21Days |
FARYDAK 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FARYDAK 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:6 /21Days |
FASLODEX 50MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in PA cover FASLODEX 50MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FAZACLO 200 MG TABLETS ORALLY DISINTEGRATING ![Compare how all Medicare Part D PDP plans in PA cover FAZACLO 200 MG TABLETS ORALLY DISINTEGRATING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FELBAMATE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FELBAMATE 600 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 600 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FELODIPINE ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FELODIPINE ER 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FELODIPINE ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FEMRING 0.05MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in PA cover FEMRING 0.05MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FEMRING 0.10MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in PA cover FEMRING 0.10MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 130 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 130 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 134MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 134MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
fenofibrate 145 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover fenofibrate 145 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 160mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 160mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 43 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 43 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 48 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 48 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOFIBRATE 54mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 54mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOFIBRATE 67MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 67MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fenofibric acid dr 135 mg capsule [TRILIPIX] ![Compare how all Medicare Part D PDP plans in PA cover Fenofibric acid dr 135 mg capsule [TRILIPIX].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fenofibric acid dr 45 mg capsule [TRILIPIX] ![Compare how all Medicare Part D PDP plans in PA cover Fenofibric acid dr 45 mg capsule [TRILIPIX].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENOPROFEN 600MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FENOPROFEN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:20 /30Days |
FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:10 /30Days |
FENTANYL 75 MCG/HR PATCH ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 75 MCG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:20 /30Days |
FENTANYL CITRATE 1600ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE 1600ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:120 /30Days |
FENTANYL CITRATE 200ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE 200ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:120 /30Days |
FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:10 /30Days |
FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:10 /30Days |
FERRIPROX 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FERRIPROX 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FETZIMA 20-40 MG TITRATION PAK ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA 20-40 MG TITRATION PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FETZIMA ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FETZIMA ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FETZIMA ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FETZIMA ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FINASTERIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FINASTERIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Firazyr 30.0mg/3mL 1 SYRINGE, GLASS per CARTON / 3 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in PA cover Firazyr 30.0mg/3mL 1 SYRINGE, GLASS per CARTON / 3 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:9 /30Days |
FIRMAGON 2 X 120 MG KIT ![Compare how all Medicare Part D PDP plans in PA cover FIRMAGON 2 X 120 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FIRMAGON 80 MG KIT ![Compare how all Medicare Part D PDP plans in PA cover FIRMAGON 80 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLAREX 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover FLAREX 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLAVOXATE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLAVOXATE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLEBOGAMMA DIF INJECTION ![Compare how all Medicare Part D PDP plans in PA cover FLEBOGAMMA DIF INJECTION .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FLECAINIDE ACETATE 100 MG TAB #60 EA ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 100 MG TAB #60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLECAINIDE ACETATE 150 MG TAB 360 EA ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 150 MG TAB 360 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLECAINIDE ACETATE 50 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLECTOR PATCH ![Compare how all Medicare Part D PDP plans in PA cover FLECTOR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PA cover FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUCONAZOLE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUCONAZOLE 10MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 10MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUCONAZOLE 150MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluconazole 200mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluconazole 200mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUCONAZOLE 40MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 40MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Fluconazole 50mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluconazole 50mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Flucytosine 250mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Flucytosine 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Flucytosine 500mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Flucytosine 500mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUDARABINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FLUDARABINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in PA cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOCINOLONE 0.01% BODY OIL ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% BODY OIL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOCINOLONE 0.01% CREAM ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOCINOLONE 0.01% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOCINOLONE 0.025% CREAM ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINOLONE 0.025% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.025% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOCINOLONE OIL 0.01% EAR DRP ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE OIL 0.01% EAR DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
fluocinonide 0.1% cream ![Compare how all Medicare Part D PDP plans in PA cover fluocinonide 0.1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluocinonide 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluorometholone 0.1% drops ![Compare how all Medicare Part D PDP plans in PA cover Fluorometholone 0.1% drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOROURACIL 0.5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 0.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOROURACIL 2% TOPICAL SOLN ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 2% TOPICAL SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOROURACIL 5% TOP SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 5% TOP SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
fluorouracil 500 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in PA cover fluorouracil 500 mg/10 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FLUOROURACIL CREA 5% ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL CREA 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluoxetine 10mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluoxetine 10mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOXETINE 40MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE 40MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOXETINE CAPSULES 10MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE CAPSULES 10MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOXETINE DR 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE DR 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOXETINE HCL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUOXETINE HCL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluoxetine Hydrochloride 20mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluoxetine Hydrochloride 20mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUPHENAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUPHENAZINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUPHENAZINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluphenazine Decanoate 25mg/mL ![Compare how all Medicare Part D PDP plans in PA cover Fluphenazine Decanoate 25mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE HCL 2.5MG/5ML ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLURBIPROFEN 0.03% EYE DROP ![Compare how all Medicare Part D PDP plans in PA cover FLURBIPROFEN 0.03% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLURBIPROFEN 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLURBIPROFEN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Flutamide 125mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Flutamide 125mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUTICASONE PROP 0.05% LOTION ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE PROP 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluticasone Propionate 0.05mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluticasone Propionate 0.05mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in PA cover FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in PA cover FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
fluvoxamine er 100 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover fluvoxamine er 100 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
fluvoxamine er 150 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover fluvoxamine er 150 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FLUVOXAMINE MALEATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE MALEATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluvoxamine Maleate 25mg/1 100 BOTTLE, PLASTIC in 1 BOTTLE, PLASTIC / 100 FILM COATED TABLETS in ![Compare how all Medicare Part D PDP plans in PA cover Fluvoxamine Maleate 25mg/1 100 BOTTLE, PLASTIC in 1 BOTTLE, PLASTIC / 100 FILM COATED TABLETS in .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fluvoxamine maleate 50mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fluvoxamine maleate 50mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FML FORTE 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover FML FORTE 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FML S.O.P. 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover FML S.O.P. 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOLOTYN 20mg/mL 1 VIAL, SINGLE-USE per CARTON / 2 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in PA cover FOLOTYN 20mg/mL 1 VIAL, SINGLE-USE per CARTON / 2 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fomepizole 1g/mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PA cover Fomepizole 1g/mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fondaparinux Sodium 10mg/0.8mL 2 SYRINGES per CARTON / 0.8 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 10mg/0.8mL 2 SYRINGES per CARTON / 0.8 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:11 /14Days |
Fondaparinux Sodium 2.5mg/0.5mL 2 SYRINGES per CARTON / 0.5 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 2.5mg/0.5mL 2 SYRINGES per CARTON / 0.5 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:7 /14Days |
Fondaparinux Sodium 5mg/4mL 2 SYRINGES per CARTON / 0.4 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 5mg/4mL 2 SYRINGES per CARTON / 0.4 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:6 /14Days |
Fondaparinux Sodium 7.5mg/0.6mL 2 SYRINGES per CARTON / 0.6 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover Fondaparinux Sodium 7.5mg/0.6mL 2 SYRINGES per CARTON / 0.6 mL in 1 SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:8 /14Days |
FORADIL AEROLIZER 12 MCG CAP ![Compare how all Medicare Part D PDP plans in PA cover FORADIL AEROLIZER 12 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FORFIVO XL 450 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FORFIVO XL 450 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | Q:30 /30Days |
Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in PA cover FORTICAL 200 U/DOSE AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSAMAX PLUS D 70; 5600mg/1; [iU]/1 4 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover FOSAMAX PLUS D 70; 5600mg/1; [iU]/1 4 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSAMAX PLUS D 70MG/2800 IU ![Compare how all Medicare Part D PDP plans in PA cover FOSAMAX PLUS D 70MG/2800 IU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSCARNET 24MG/ML INFUS BTTL ![Compare how all Medicare Part D PDP plans in PA cover FOSCARNET 24MG/ML INFUS BTTL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P |
FOSINOPRIL SODIUM 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSINOPRIL SODIUM 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fosinopril Sodium 40mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Fosinopril Sodium 40mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSINOPRIL-HCTZ 10-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL-HCTZ 10-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSINOPRIL-HCTZ 20-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL-HCTZ 20-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Fosphenytoin Sodium 50mg/mL 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PA cover Fosphenytoin Sodium 50mg/mL 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSRENOL 1,000 MG POWDER PACK ![Compare how all Medicare Part D PDP plans in PA cover FOSRENOL 1,000 MG POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSRENOL 1000MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PA cover FOSRENOL 1000MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSRENOL 500MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PA cover FOSRENOL 500MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSRENOL 750 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in PA cover FOSRENOL 750 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FOSRENOL 750MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PA cover FOSRENOL 750MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FUROSEMIDE 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Furosemide 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Furosemide 40 mg/4 ml vial ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 40 mg/4 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Furosemide 40mg/1 5000 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 40mg/1 5000 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FUROSEMIDE 80MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 80MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FUSILEV I.V. 50 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FUSILEV I.V. 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FUZEON 90 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FUZEON 90 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | None |
FYCOMPA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days |
FYCOMPA 12 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days |
FYCOMPA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days |
FYCOMPA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days |
FYCOMPA 6 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days |
FYCOMPA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days |