2015 Medicare Part D Plan Formulary Information |
SecureCare - Option II (HMO) (H5151-011-2)
Benefit Details
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The SecureCare - Option II (HMO) (H5151-011-2) Formulary Drugs Starting with the Letter B in PLEASANTS County, WV: CMS MA Region 6 which includes: WV Plan Monthly Premium: $97.00 Deductible: $0 |
Drugs Starting with Letter B
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
BACiiM 500001/1 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in WV cover BACiiM 500001/1 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Bacitracin 500 unit/gm Eye Ointment ![Compare how all Medicare Part D PDP plans in WV cover Bacitracin 500 unit/gm Eye Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BACITRACIN INJ 50000UNT ![Compare how all Medicare Part D PDP plans in WV cover BACITRACIN INJ 50000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT ![Compare how all Medicare Part D PDP plans in WV cover BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BACLOFEN 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BACLOFEN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BACLOFEN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BACLOFEN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT) ![Compare how all Medicare Part D PDP plans in WV cover BALSALAZIDE DISODIUM 750MG CAPSULE (280 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Balziva 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in WV cover Balziva 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Banzel 200mg/1 ![Compare how all Medicare Part D PDP plans in WV cover Banzel 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Banzel 40mg/mL ![Compare how all Medicare Part D PDP plans in WV cover Banzel 40mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BANZEL TABLET 400MG ![Compare how all Medicare Part D PDP plans in WV cover BANZEL TABLET 400MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BARACLUDE 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BARACLUDE 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
BARACLUDE 1MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BARACLUDE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
BCG VACCINE 50mg/1 1 VIAL per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in WV cover BCG VACCINE 50mg/1 1 VIAL per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BELEODAQ 500 MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover BELEODAQ 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
BENAZEPRIL HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENAZEPRIL HCL 20mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL 20mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENAZEPRIL HCL 40MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENAZEPRIL HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL-HCTZ TABLET 10-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL-HCTZ TABLET 20-12.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL-HCTZ TABLET 20-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BENAZEPRIL HCL-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BENLYSTA 120mg/1.5mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WV cover BENLYSTA 120mg/1.5mL 1 VIAL per CARTON / 1.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BENZTROPINE 2 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover BENZTROPINE 2 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Benztropine mes 2 mg tablet ![Compare how all Medicare Part D PDP plans in WV cover Benztropine mes 2 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BENZTROPINE MESYLATE 0.5 MG TABLETS ![Compare how all Medicare Part D PDP plans in WV cover BENZTROPINE MESYLATE 0.5 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Benztropine Mesylate 1mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Benztropine Mesylate 1mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Betamethasone Dipropionate 0.5mg/g 1 TUBE in 1 CARTON / 50 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WV cover Betamethasone Dipropionate 0.5mg/g 1 TUBE in 1 CARTON / 50 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Betamethasone Dipropionate 0.60mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Betamethasone Dipropionate 0.60mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Betamethasone Dipropionate 0.64mg/g / 45 g TUBE ![Compare how all Medicare Part D PDP plans in WV cover Betamethasone Dipropionate 0.64mg/g / 45 g TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Betamethasone Dipropionate 0.64mg/mL 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Betamethasone Dipropionate 0.64mg/mL 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Betamethasone DP 0.05% ointment ![Compare how all Medicare Part D PDP plans in WV cover Betamethasone DP 0.05% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETAMETHASONE DP AUG 0.05% GEL ![Compare how all Medicare Part D PDP plans in WV cover BETAMETHASONE DP AUG 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETAMETHASONE VALERATE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in WV cover BETAMETHASONE VALERATE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETAMETHASONE VALERATE 0.12% FOAM ![Compare how all Medicare Part D PDP plans in WV cover BETAMETHASONE VALERATE 0.12% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETAMETHASONE VALERATE CREAM ![Compare how all Medicare Part D PDP plans in WV cover BETAMETHASONE VALERATE CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETAMETHASONE VALERATE OINTMENT USP ![Compare how all Medicare Part D PDP plans in WV cover BETAMETHASONE VALERATE OINTMENT USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM ![Compare how all Medicare Part D PDP plans in WV cover BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:15 /28Days |
Betaxolol 10mg/1 ![Compare how all Medicare Part D PDP plans in WV cover Betaxolol 10mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Betaxolol 20mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Betaxolol 20mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Betaxolol hcl 0.5% eye drop ![Compare how all Medicare Part D PDP plans in WV cover Betaxolol hcl 0.5% eye drop.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETHANECHOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BETHANECHOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETHANECHOL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BETHANECHOL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETHANECHOL CHLORIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BETHANECHOL CHLORIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETHANECHOL CHLORIDE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BETHANECHOL CHLORIDE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BETHKIS 300 MG/4 ML AMPULE ![Compare how all Medicare Part D PDP plans in WV cover BETHKIS 300 MG/4 ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:224 /28Days |
BEXSERO PREFILLED SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover BEXSERO PREFILLED SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Bicalutamide 50mL/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WV cover Bicalutamide 50mL/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BICILL LA PFS 600MU 1ML PED ![Compare how all Medicare Part D PDP plans in WV cover BICILL LA PFS 600MU 1ML PED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BICILLIN C-R 1.2MM UNITS SYR 2ML x 10 ![Compare how all Medicare Part D PDP plans in WV cover BICILLIN C-R 1.2MM UNITS SYR 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BICILLIN C-R 900/300 SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in WV cover BICILLIN C-R 900/300 SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BICILLIN LA PFS 1200MU 2ML ![Compare how all Medicare Part D PDP plans in WV cover BICILLIN LA PFS 1200MU 2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BICILLIN LA. 600000UNIT/ML 1ML ![Compare how all Medicare Part D PDP plans in WV cover BICILLIN LA. 600000UNIT/ML 1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BICNU 100 MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover BICNU 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BIMATOPROST 0.03% EYE DROPS [Lumigan] ![Compare how all Medicare Part D PDP plans in WV cover BIMATOPROST 0.03% EYE DROPS [Lumigan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BISOPROLOL FUMARATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BISOPROLOL FUMARATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BISOPROLOL FUMARATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BISOPROLOL FUMARATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover BISOPROLOL FUMARATE-HCTZ TABLET 10-6.25MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BISOPROLOL FUMARATE-HCTZ TABLET 2.5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover BISOPROLOL FUMARATE-HCTZ TABLET 5-6.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BLEOMYCIN SULFATE 30UNITS VIA ![Compare how all Medicare Part D PDP plans in WV cover BLEOMYCIN SULFATE 30UNITS VIA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BLEPHAMIDE 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover BLEPHAMIDE 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BLEPHAMIDE 10-0.2% EYE OINT ![Compare how all Medicare Part D PDP plans in WV cover BLEPHAMIDE 10-0.2% EYE OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BOOSTRIX TDAP VACCINE SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover BOOSTRIX TDAP VACCINE SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BOOSTRIX TDAP VACCINE VIAL ![Compare how all Medicare Part D PDP plans in WV cover BOOSTRIX TDAP VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
BOSULIF 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BOSULIF 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
BOSULIF 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BOSULIF 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
BOTOX 100UNITS VIAL ![Compare how all Medicare Part D PDP plans in WV cover BOTOX 100UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | P |
BOTOX 200[USP'U]/1 1 VIAL in 1 CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in WV cover BOTOX 200[USP'U]/1 1 VIAL in 1 CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | P |
BRIELLYN TABLET ![Compare how all Medicare Part D PDP plans in WV cover BRIELLYN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BRILINTA 90mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover BRILINTA 90mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | None |
Brimonidine Tartrate 1.5mg/mL ![Compare how all Medicare Part D PDP plans in WV cover Brimonidine Tartrate 1.5mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL ![Compare how all Medicare Part D PDP plans in WV cover BRIMONIDINE TARTRATE OPHTHALMIC SOLUTION 0.2% 10ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
BRINTELLIX 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BRINTELLIX 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BRINTELLIX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BRINTELLIX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:30 /30Days |
BRINTELLIX 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BRINTELLIX 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:120 /30Days |
Bromfenac 1.035mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in WV cover Bromfenac 1.035mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Bromocriptine mesylate 2.5mg/1 24 BOTTLE per CARTON / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Bromocriptine mesylate 2.5mg/1 24 BOTTLE per CARTON / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BROMOCRIPTINE MESYLATE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover BROMOCRIPTINE MESYLATE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUDESONIDE 0.25 MG/2 ML SUSP ![Compare how all Medicare Part D PDP plans in WV cover BUDESONIDE 0.25 MG/2 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | P |
BUDESONIDE 0.5 MG/2 ML SUSP ![Compare how all Medicare Part D PDP plans in WV cover BUDESONIDE 0.5 MG/2 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | P |
Budesonide 32 mcg nasal spray ![Compare how all Medicare Part D PDP plans in WV cover Budesonide 32 mcg nasal spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:17 /30Days |
Budesonide 3mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Budesonide 3mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
BUMETANIDE 0.25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover BUMETANIDE 0.25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Bumetanide 0.5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Bumetanide 0.5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Bumetanide 1mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WV cover Bumetanide 1mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
Bumetanide 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Bumetanide 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$10.00 | $20.00 | None |
buprenorphin-naloxon 2-0.5 mg tb ![Compare how all Medicare Part D PDP plans in WV cover buprenorphin-naloxon 2-0.5 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | P Q:360 /30Days |
buprenorphin-naloxon 8-2 mg tb ![Compare how all Medicare Part D PDP plans in WV cover buprenorphin-naloxon 8-2 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | P Q:90 /30Days |
BUPRENORPHINE 0.3MG/ML SYRN ![Compare how all Medicare Part D PDP plans in WV cover BUPRENORPHINE 0.3MG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:267 /30Days |
Buprenorphine HCl 2mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Buprenorphine HCl 2mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:300 /30Days |
Buprenorphine HCl 8mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Buprenorphine HCl 8mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:75 /30Days |
BUPROBAN ER 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BUPROBAN ER 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUPROPION HCL SR 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BUPROPION HCL SR 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:120 /30Days |
BUPROPION HCL SR 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover BUPROPION HCL SR 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:60 /30Days |
BUPROPION HCL XL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BUPROPION HCL XL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPROPION HCL XL 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BUPROPION HCL XL 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:60 /30Days |
Bupropion Hydrochloride 100mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Bupropion Hydrochloride 100mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
Bupropion Hydrochloride 150mg/1 100 TABLET, ER in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Bupropion Hydrochloride 150mg/1 100 TABLET, ER in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:90 /30Days |
BUPROPION HYDROCHLORIDE 75mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover BUPROPION HYDROCHLORIDE 75mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUSPIRONE HCL 15MG TABLET (180 CT) ![Compare how all Medicare Part D PDP plans in WV cover BUSPIRONE HCL 15MG TABLET (180 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUSPIRONE HCL 30MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in WV cover BUSPIRONE HCL 30MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUSPIRONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BUSPIRONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUSPIRONE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover BUSPIRONE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUSPIRONE HYDROCHLORIDE 10 MG TABLETS ![Compare how all Medicare Part D PDP plans in WV cover BUSPIRONE HYDROCHLORIDE 10 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | None |
BUSULFEX 6mg/mL ![Compare how all Medicare Part D PDP plans in WV cover BUSULFEX 6mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Butorphanol 1 mg/ml vial ![Compare how all Medicare Part D PDP plans in WV cover Butorphanol 1 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:720 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUTORPHANOL 10MG/ML SPRAY ![Compare how all Medicare Part D PDP plans in WV cover BUTORPHANOL 10MG/ML SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:40 /30Days |
Butorphanol 2 mg/ml vial ![Compare how all Medicare Part D PDP plans in WV cover Butorphanol 2 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$20.00 | $40.00 | Q:360 /30Days |
BYDUREON 2 MG PEN INJECT ![Compare how all Medicare Part D PDP plans in WV cover BYDUREON 2 MG PEN INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | P Q:4 /28Days |
BYDUREON 2 MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover BYDUREON 2 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | P Q:4 /28Days |
BYETTA 10 MCG DOSE PEN INJ ![Compare how all Medicare Part D PDP plans in WV cover BYETTA 10 MCG DOSE PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | P Q:2 /30Days |
BYETTA 5 MCG DOSE PEN INJ ![Compare how all Medicare Part D PDP plans in WV cover BYETTA 5 MCG DOSE PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $90.00 | P Q:1 /30Days |