2015 Medicare Part D Plan Formulary Information |
Blue Cross MedicareRx Basic (PDP) (S5715-012-0)
Benefit Details
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The Blue Cross MedicareRx Basic (PDP) (S5715-012-0) Formulary Drugs Starting with the Letter F in CMS PDP Region 17 which includes: IL Plan Monthly Premium: $26.40 Deductible: $320 Qualifies for LIS: Yes |
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 |
FABRAZYME 35MG VIAL ![Compare how all Medicare Part D PDP plans in IL cover FABRAZYME 35MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
FALMINA-28 TABLET ![Compare how all Medicare Part D PDP plans in IL cover FALMINA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FAMOTIDINE 20MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IL cover FAMOTIDINE 20MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
FAMOTIDINE 40MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FAMOTIDINE 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD ![Compare how all Medicare Part D PDP plans in IL cover FAMOTIDINE INJECTION 10MG 25 X 2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FANAPT 1 KIT in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 1 KIT in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:56 /28Days |
FANAPT 1 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 1 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
FANAPT 10 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 10 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
FANAPT 12 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 12 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
FANAPT 2 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 2 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 4 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 4 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
FANAPT 6 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 6 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
FANAPT 8 MG 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FANAPT 8 MG 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
FARESTON 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FARESTON 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
FARYDAK 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FARYDAK 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /21Days |
FARYDAK 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FARYDAK 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /21Days |
FARYDAK 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FARYDAK 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /21Days |
FASLODEX 50MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in IL cover FASLODEX 50MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
FazaClo 100mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FazaClo 100mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:90 /30Days |
FazaClo 12.5mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FazaClo 12.5mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:90 /30Days |
FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FazaClo 150mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FAZACLO 200 MG TABLETS ORALLY DISINTEGRATING ![Compare how all Medicare Part D PDP plans in IL cover FAZACLO 200 MG TABLETS ORALLY DISINTEGRATING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:120 /30Days |
FazaClo 25mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FazaClo 25mg/1 100 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:270 /30Days |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FELBAMATE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FELBAMATE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FELBAMATE 600 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IL cover FELBAMATE 600 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FENOFIBRATE 134MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FENOFIBRATE 134MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
fenofibrate 145 mg tablet ![Compare how all Medicare Part D PDP plans in IL cover fenofibrate 145 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
FENOFIBRATE 160mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FENOFIBRATE 160mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
FENOFIBRATE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FENOFIBRATE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
FENOFIBRATE 48 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FENOFIBRATE 48 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:60 /30Days |
FENOFIBRATE 54mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover FENOFIBRATE 54mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOFIBRATE 67MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FENOFIBRATE 67MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL 100MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:15 /30Days |
FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:15 /30Days |
FENTANYL 75 MCG/HR PATCH ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL 75 MCG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:15 /30Days |
FENTANYL CITRATE 1600ug/1 30 BLISTER PACK per CARTON / 1 LOZENGE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IL 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) |
5 |
Specialty Tier |
25% | N/A | 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 IL 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) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
FENTANYL CITRATE LOZENGES ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL CITRATE LOZENGES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL TRANSDERMAL SYSTEM 25MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:15 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN ![Compare how all Medicare Part D PDP plans in IL cover FENTANYL TRANSDERMAL SYSTEM 50MCG 5 SYSTEMS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:15 /30Days |
FETZIMA 20-40 MG TITRATION PAK ![Compare how all Medicare Part D PDP plans in IL cover FETZIMA 20-40 MG TITRATION PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:28 /28Days |
FETZIMA ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FETZIMA ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:30 /30Days |
FETZIMA ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FETZIMA ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:30 /30Days |
FETZIMA ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FETZIMA ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:30 /30Days |
FETZIMA ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover FETZIMA ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:30 /30Days |
FINACEA 15% GEL ![Compare how all Medicare Part D PDP plans in IL cover FINACEA 15% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FINASTERIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FINASTERIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
Firazyr 30.0mg/3mL 1 SYRINGE, GLASS per CARTON / 3 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in IL 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) |
5 |
Specialty Tier |
25% | N/A | P Q:18 /30Days |
FIRMAGON 2 X 120 MG KIT ![Compare how all Medicare Part D PDP plans in IL cover FIRMAGON 2 X 120 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
FIRMAGON 80 MG KIT ![Compare how all Medicare Part D PDP plans in IL cover FIRMAGON 80 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLECAINIDE ACETATE 100 MG TAB #60 EA ![Compare how all Medicare Part D PDP plans in IL cover FLECAINIDE ACETATE 100 MG TAB #60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLECAINIDE ACETATE 150 MG TAB 360 EA ![Compare how all Medicare Part D PDP plans in IL cover FLECAINIDE ACETATE 150 MG TAB 360 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLECAINIDE ACETATE 50 MG TAB ![Compare how all Medicare Part D PDP plans in IL cover FLECAINIDE ACETATE 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in IL cover FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $135.00 | Q:60 /30Days |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in IL cover FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $135.00 | Q:240 /30Days |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in IL cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $135.00 | Q:60 /30Days |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in IL cover FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $135.00 | Q:12 /30Days |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in IL cover FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $135.00 | Q:24 /30Days |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in IL cover FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $135.00 | Q:11 /30Days |
FLUCONAZOLE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FLUCONAZOLE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUCONAZOLE 10MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IL cover FLUCONAZOLE 10MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUCONAZOLE 150MG TABLETS ![Compare how all Medicare Part D PDP plans in IL cover FLUCONAZOLE 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Fluconazole 200mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Fluconazole 200mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUCONAZOLE 40MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IL cover FLUCONAZOLE 40MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Fluconazole 50mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Fluconazole 50mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR ![Compare how all Medicare Part D PDP plans in IL cover FLUCONAZOLE INJECTION 200MG 6 X 200/250ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Flucytosine 250mg/1 ![Compare how all Medicare Part D PDP plans in IL cover Flucytosine 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Flucytosine 500mg/1 ![Compare how all Medicare Part D PDP plans in IL cover Flucytosine 500mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
FLUDARABINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in IL cover FLUDARABINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IL cover FLUDROCORTISONE ACETATE 0.1MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUOCINOLONE OIL 0.01% EAR DRP ![Compare how all Medicare Part D PDP plans in IL cover FLUOCINOLONE OIL 0.01% EAR DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IL 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) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Fluocinonide 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IL 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) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Fluorometholone 0.1% drops ![Compare how all Medicare Part D PDP plans in IL cover Fluorometholone 0.1% drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
fluorouracil 500 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in IL cover fluorouracil 500 mg/10 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | P |
FLUOROURACIL CREA 5% ![Compare how all Medicare Part D PDP plans in IL cover FLUOROURACIL CREA 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
Fluoxetine 10mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Fluoxetine 10mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IL cover Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:600 /30Days |
FLUOXETINE 40MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in IL cover FLUOXETINE 40MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:60 /30Days |
FLUOXETINE CAPSULES 10MG (100 CT) ![Compare how all Medicare Part D PDP plans in IL cover FLUOXETINE CAPSULES 10MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | Q:30 /30Days |
FLUOXETINE HCL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FLUOXETINE HCL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:120 /30Days |
Fluoxetine Hydrochloride 20mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Fluoxetine Hydrochloride 20mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | Q:120 /30Days |
FLUPHENAZINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FLUPHENAZINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | 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 IL cover FLUPHENAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUPHENAZINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FLUPHENAZINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IL cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FLUPHENAZINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FLUPHENAZINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in IL cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
Fluphenazine Decanoate 25mg/mL ![Compare how all Medicare Part D PDP plans in IL cover Fluphenazine Decanoate 25mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR ![Compare how all Medicare Part D PDP plans in IL cover FLUPHENAZINE HCL 2.5MG/5ML ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FLURBIPROFEN 0.03% EYE DROP ![Compare how all Medicare Part D PDP plans in IL cover FLURBIPROFEN 0.03% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Flutamide 125mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Flutamide 125mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in IL cover FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:16 /30Days |
FLUVOXAMINE MALEATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FLUVOXAMINE MALEATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 IL 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) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
Fluvoxamine maleate 50mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Fluvoxamine maleate 50mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | Q:30 /30Days |
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 IL 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) |
5 |
Specialty Tier |
25% | N/A | 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 IL 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) |
5 |
Specialty Tier |
25% | N/A | Q:24 /90Days |
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 IL 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) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:15 /90Days |
Fondaparinux Sodium 5mg/4mL 2 SYRINGES per CARTON / 0.4 mL in 1 SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in IL 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) |
5 |
Specialty Tier |
25% | N/A | Q:12 /90Days |
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 IL 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) |
5 |
Specialty Tier |
25% | N/A | Q:18 /90Days |
FORADIL AEROLIZER 12 MCG CAP ![Compare how all Medicare Part D PDP plans in IL cover FORADIL AEROLIZER 12 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | Q:60 /30Days |
Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in IL 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) |
5 |
Specialty Tier |
25% | N/A | P |
FOSCARNET 24MG/ML INFUS BTTL ![Compare how all Medicare Part D PDP plans in IL cover FOSCARNET 24MG/ML INFUS BTTL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | P |
FOSINOPRIL SODIUM 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IL cover FOSINOPRIL SODIUM 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSINOPRIL SODIUM 20MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FOSINOPRIL SODIUM 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
Fosinopril Sodium 40mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Fosinopril Sodium 40mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
Fosphenytoin Sodium 50mg/mL 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in IL cover Fosphenytoin Sodium 50mg/mL 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FOSRENOL 1,000 MG POWDER PACK ![Compare how all Medicare Part D PDP plans in IL cover FOSRENOL 1,000 MG POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FOSRENOL 1000MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IL cover FOSRENOL 1000MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FOSRENOL 500MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IL cover FOSRENOL 500MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FOSRENOL 750 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in IL cover FOSRENOL 750 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FOSRENOL 750MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IL cover FOSRENOL 750MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | 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 IL 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) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
FUROSEMIDE 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IL cover FUROSEMIDE 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Furosemide 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover Furosemide 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Furosemide 40 mg/4 ml vial ![Compare how all Medicare Part D PDP plans in IL cover Furosemide 40 mg/4 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $30.00 | None |
Furosemide 40mg/1 5000 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IL cover Furosemide 40mg/1 5000 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
FUROSEMIDE 80MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IL cover FUROSEMIDE 80MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $18.00 | None |
FUZEON 90 MG VIAL ![Compare how all Medicare Part D PDP plans in IL cover FUZEON 90 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:60 /30Days |
FYCOMPA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FYCOMPA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FYCOMPA 12 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FYCOMPA 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FYCOMPA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FYCOMPA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FYCOMPA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FYCOMPA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FYCOMPA 6 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FYCOMPA 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |
FYCOMPA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover FYCOMPA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $285.00 | None |