2015 Medicare Part D Plan Formulary Information |
PriorityMedicare Select (PPO) (H4875-017-3)
Benefit Details
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The PriorityMedicare Select (PPO) (H4875-017-3) Formulary Drugs Starting with the Letter V in ALCONA County, MI: CMS MA Region 11 which includes: MI Plan Monthly Premium: $145.00 Deductible: $0 |
Drugs Starting with Letter V
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
VAGIFEM 10 MCG VAGINAL TAB ![Compare how all Medicare Part D PDP plans in MI cover VAGIFEM 10 MCG VAGINAL TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VALACYCLOVIR 1000 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in MI cover VALACYCLOVIR 1000 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALACYCLOVIR 500 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in MI cover VALACYCLOVIR 500 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALCHLOR 0.016% GEL ![Compare how all Medicare Part D PDP plans in MI cover VALCHLOR 0.016% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
VALCYTE 450MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VALCYTE 450MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VALGANCICLOVIR 450 MG TABLET [Valcyte] ![Compare how all Medicare Part D PDP plans in MI cover VALGANCICLOVIR 450 MG TABLET [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VALPROATE SODIUM 500 mg/5 ml vl ![Compare how all Medicare Part D PDP plans in MI cover VALPROATE SODIUM 500 mg/5 ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Valproic 250mg/1 100 CAPSULE, LIQUID FILLED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Valproic 250mg/1 100 CAPSULE, LIQUID FILLED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Valproic Acid 250mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Valproic Acid 250mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN 160 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN 160 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VALSARTAN 320 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN 320 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN 40 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN 40 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN 80 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN 80 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN-HCTZ 160-25 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN-HCTZ 160-25 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN-HCTZ 320-12.5 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN-HCTZ 320-12.5 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN-HCTZ 320-25 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN-HCTZ 320-25 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VALSARTAN-HCTZ 80-12.5 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in MI cover VALSARTAN-HCTZ 80-12.5 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VANCOMYCIN HCL 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover VANCOMYCIN HCL 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VANCOMYCIN HCL 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover VANCOMYCIN HCL 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE ) ![Compare how all Medicare Part D PDP plans in MI cover VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE ).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VANCOMYCIN HYDROCHLORIDE 100mg/mL 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA ![Compare how all Medicare Part D PDP plans in MI cover VANCOMYCIN HYDROCHLORIDE 100mg/mL 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VANCOMYCIN HYDROCHLORIDE 500MG/100ML INJECTION (STERILE) ![Compare how all Medicare Part D PDP plans in MI cover VANCOMYCIN HYDROCHLORIDE 500MG/100ML INJECTION (STERILE).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VAQTA 25 UNITS/0.5ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover VAQTA 25 UNITS/0.5ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VAQTA 25 UNITS/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover VAQTA 25 UNITS/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VAQTA 50 UNITS/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover VAQTA 50 UNITS/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VARIVAX VACCINE W/DILUENT ![Compare how all Medicare Part D PDP plans in MI cover VARIVAX VACCINE W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VASCEPA 1 GM CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover VASCEPA 1 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | P |
Vectibix 100mg/5mL 1 VIAL, SINGLE-USE per CARTON / 5 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in MI cover Vectibix 100mg/5mL 1 VIAL, SINGLE-USE per CARTON / 5 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
VELCADE 3.5MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover VELCADE 3.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Velivet Triphasic Regimen 3 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 Velivet Triphasic Regimen 3 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 |
$9.00 | $22.50 | None |
VELPHORO 500 MG CHEWABLE TAB ![Compare how all Medicare Part D PDP plans in MI cover VELPHORO 500 MG CHEWABLE TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VENLAFAXINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HCL 25MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HCL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HCL 37.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HCL 37.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HCL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HCL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HCL 75MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HCL 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HCL ER TAB 225 MG ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HCL ER TAB 225 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VENLAFAXINE HYDROCHLORIDE 150MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HYDROCHLORIDE 150MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HYDROCHLORIDE 150MG TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HYDROCHLORIDE 150MG TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HYDROCHLORIDE 37.5MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HYDROCHLORIDE 37.5MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HYDROCHLORIDE 37.5MG TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HYDROCHLORIDE 37.5MG TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VENLAFAXINE HYDROCHLORIDE 75MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HYDROCHLORIDE 75MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VENLAFAXINE HYDROCHLORIDE 75MG TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VENLAFAXINE HYDROCHLORIDE 75MG TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Ventavis 0.01mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Ventavis 0.01mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Ventavis 0.02mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Ventavis 0.02mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
VENTOLIN HFA 90MCG INHALER ![Compare how all Medicare Part D PDP plans in MI cover VENTOLIN HFA 90MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VERAMYST 27.5MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in MI cover VERAMYST 27.5MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VERAPAMIL 120MG CAP PELLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL 120MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL 180MG CAP PELLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL 180MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL 240MG CAP PELLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL 240MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL ER 120 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL ER 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VERAPAMIL ER 180 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL ER 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL ER 300MG CAPSULE 24HR SR PELLETS ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL ER 300MG CAPSULE 24HR SR PELLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL HCL 120MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL HCL 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VERAPAMIL HCL 80MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VERAPAMIL HCL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Verapamil Hydrochloride 240mg/1 500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Verapamil Hydrochloride 240mg/1 500 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VEREGEN 15% OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover VEREGEN 15% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VERSACLOZ 50 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MI cover VERSACLOZ 50 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | S |
VEXOL 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover VEXOL 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VFEND 200MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VFEND 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VFEND 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VFEND 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VICTOZA 3-PAK 18 MG/3 ML PEN ![Compare how all Medicare Part D PDP plans in MI cover VICTOZA 3-PAK 18 MG/3 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VIDAZA FOR INJECTION 100MG/VIAL 1 VIALSU ![Compare how all Medicare Part D PDP plans in MI cover VIDAZA FOR INJECTION 100MG/VIAL 1 VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VIDEX 2GM PEDIATRIC TUBEX ![Compare how all Medicare Part D PDP plans in MI cover VIDEX 2GM PEDIATRIC TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VIEKIRA PAK ![Compare how all Medicare Part D PDP plans in MI cover VIEKIRA PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:112 /28Days |
VIGABATRIN 50 MG/ML ORAL SOLUTION [SABRIL] ![Compare how all Medicare Part D PDP plans in MI cover VIGABATRIN 50 MG/ML ORAL SOLUTION [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VIGABATRIN 500 MG ORAL TABLET [SABRIL] ![Compare how all Medicare Part D PDP plans in MI cover VIGABATRIN 500 MG ORAL TABLET [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VIGAMOX 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover VIGAMOX 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VIIBRYD 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MI cover VIIBRYD 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:30 /30Days |
VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:30 /30Days |
VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE.](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 |
VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:30 /30Days |
VIMPAT 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover VIMPAT 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Vimpat 10mg/mL 10 VIAL, GLASS per CARTON / 20 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in MI cover Vimpat 10mg/mL 10 VIAL, GLASS per CARTON / 20 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VINBLASTINE 1 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover VINBLASTINE 1 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VINCRISTINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover VINCRISTINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VINCRISTINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover VINCRISTINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
VINORELBINE 10MG/ML VIAL 5ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover VINORELBINE 10MG/ML VIAL 5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$9.00 | $22.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIOKACE 10,440-39,150 UNITS TB ![Compare how all Medicare Part D PDP plans in MI cover VIOKACE 10,440-39,150 UNITS TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VIOKACE 20,880-78,300 UNITS TB ![Compare how all Medicare Part D PDP plans in MI cover VIOKACE 20,880-78,300 UNITS TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VIRACEPT 250MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIRACEPT 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VIRACEPT 625MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIRACEPT 625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VIRAMUNE 200MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIRAMUNE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
Viramune 400mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Viramune 400mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
VIRAMUNE 50MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in MI cover VIRAMUNE 50MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:1200 /30Days |
VIRAMUNE XR 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIRAMUNE XR 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:60 /30Days |
VIRAZOLE 6 GM VIAL ![Compare how all Medicare Part D PDP plans in MI cover VIRAZOLE 6 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
VIREAD 150 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIREAD 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VIREAD 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIREAD 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIREAD 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIREAD 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VIREAD 300MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VIREAD 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VIREAD POWDER ![Compare how all Medicare Part D PDP plans in MI cover VIREAD POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VITEKTA 150 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VITEKTA 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
VITEKTA 85 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover VITEKTA 85 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
Vivelle Dot 0.025mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 ![Compare how all Medicare Part D PDP plans in MI cover Vivelle Dot 0.025mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Vivelle Dot 0.0375mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 ![Compare how all Medicare Part D PDP plans in MI cover Vivelle Dot 0.0375mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Vivelle Dot 0.05mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 P ![Compare how all Medicare Part D PDP plans in MI cover Vivelle Dot 0.05mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 P.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Vivelle Dot 0.1mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 PA ![Compare how all Medicare Part D PDP plans in MI cover Vivelle Dot 0.1mg/d 3 PACKET per CARTON / 8 POUCH in 1 PACKET / 1 PATCH in 1 POUCH / 3.5 d in 1 PA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VIVELLE-DOT 0.075MG PATCH 1X3X8 POUCH CRTN ![Compare how all Medicare Part D PDP plans in MI cover VIVELLE-DOT 0.075MG PATCH 1X3X8 POUCH CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
VOLTAREN 1% GEL ![Compare how all Medicare Part D PDP plans in MI cover VOLTAREN 1% GEL.](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 |
VORICONAZOLE 200 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover VORICONAZOLE 200 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
Voriconazole 200mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Voriconazole 200mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Voriconazole 40 mg/ml susp ![Compare how all Medicare Part D PDP plans in MI cover Voriconazole 40 mg/ml susp.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Voriconazole 50mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Voriconazole 50mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
VOTRIENT 200mg/1 120 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover VOTRIENT 200mg/1 120 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
VYTORIN 10/10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover VYTORIN 10/10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VYTORIN 10/20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover VYTORIN 10/20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VYTORIN 10/40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover VYTORIN 10/40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VYTORIN 10/80MG TABLET 2500 BOT ![Compare how all Medicare Part D PDP plans in MI cover VYTORIN 10/80MG TABLET 2500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | None |
VYVANSE 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover VYVANSE 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
VYVANSE 40MG CAPSULE 100 EA ![Compare how all Medicare Part D PDP plans in MI cover VYVANSE 40MG CAPSULE 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VYVANSE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover VYVANSE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
VYVANSE 70MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover VYVANSE 70MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
VYVANSE CAPSULES 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in MI cover VYVANSE CAPSULES 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |
VYVANSE CAPSULES 60MG 100 BOT ![Compare how all Medicare Part D PDP plans in MI cover VYVANSE CAPSULES 60MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | Q:30 /30Days |