2016 Medicare Part D Plan Formulary Information |
Centers Plan for Nursing Home Care (HMO SNP) (H6988-003-0)
Benefit Details
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The Centers Plan for Nursing Home Care (HMO SNP) (H6988-003-0) Formulary Drugs Starting with the Letter S in Bronx County, NY: CMS MA Region 3 which includes: NY Plan Monthly Premium: $39.70 Deductible: $360 |
Drugs Starting with Letter S
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
SAIZEN 5 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SAIZEN 5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SAIZEN 8.8 MG CLICK.EASY CARTG ![Compare how all Medicare Part D PDP plans in NY cover SAIZEN 8.8 MG CLICK.EASY CARTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SAIZEN 8.8 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SAIZEN 8.8 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SANDOSTATIN LAR DEPOT 10 MG KT ![Compare how all Medicare Part D PDP plans in NY cover SANDOSTATIN LAR DEPOT 10 MG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SANDOSTATIN LAR DEPOT 20 MG KT ![Compare how all Medicare Part D PDP plans in NY cover SANDOSTATIN LAR DEPOT 20 MG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SANDOSTATIN LAR DEPOT 30 MG KT ![Compare how all Medicare Part D PDP plans in NY cover SANDOSTATIN LAR DEPOT 30 MG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SANTYL OINTMENT ![Compare how all Medicare Part D PDP plans in NY cover SANTYL OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SAPHRIS 10 MG TAB SL BLK CHERY ![Compare how all Medicare Part D PDP plans in NY cover SAPHRIS 10 MG TAB SL BLK CHERY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:60 /30Days |
SAPHRIS 2.5 MG TAB SL BLK CHRY ![Compare how all Medicare Part D PDP plans in NY cover SAPHRIS 2.5 MG TAB SL BLK CHRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:60 /30Days |
SAPHRIS 5 MG TAB SL BLK CHERRY ![Compare how all Medicare Part D PDP plans in NY cover SAPHRIS 5 MG TAB SL BLK CHERRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SAVELLA TABLETS 100MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in NY cover SAVELLA TABLETS 100MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days |
SAVELLA TABLETS 12.5MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in NY cover SAVELLA TABLETS 12.5MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days |
SAVELLA TABLETS 25MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in NY cover SAVELLA TABLETS 25MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days |
SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM ![Compare how all Medicare Part D PDP plans in NY cover SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days |
SAVELLA TALBETS 50MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in NY cover SAVELLA TALBETS 50MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days |
SELEGILINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SELEGILINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SELEGILINE HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SELEGILINE HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SENSIPAR 30MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SENSIPAR 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SENSIPAR 60MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SENSIPAR 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SENSIPAR 90MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SENSIPAR 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SEREVENT DIS AER 50MCG ![Compare how all Medicare Part D PDP plans in NY cover SEREVENT DIS AER 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in NY cover Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in NY cover Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SERTRALINE HCL 100MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NY cover SERTRALINE HCL 100MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SERTRALINE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SERTRALINE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SERTRALINE HCL 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NY cover SERTRALINE HCL 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SERTRALINE HYDROCHLORIDE 20MG/ML ORAL CONCENTRATE ![Compare how all Medicare Part D PDP plans in NY cover SERTRALINE HYDROCHLORIDE 20MG/ML ORAL CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SETLAKIN 0.15 MG-0.03 MG TAB ![Compare how all Medicare Part D PDP plans in NY cover SETLAKIN 0.15 MG-0.03 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:91 /84Days |
SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA] ![Compare how all Medicare Part D PDP plans in NY cover SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA] ![Compare how all Medicare Part D PDP plans in NY cover SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
SHAROBEL 0.35 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SHAROBEL 0.35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Signifor .3 mg/mL ![Compare how all Medicare Part D PDP plans in NY cover Signifor .3 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:60 /30Days |
Signifor .6 mg/mL ![Compare how all Medicare Part D PDP plans in NY cover Signifor .6 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:60 /30Days |
Signifor .9 mg/mL ![Compare how all Medicare Part D PDP plans in NY cover Signifor .9 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:60 /30Days |
Sildenafil 10 mg/12.5 ml vial ![Compare how all Medicare Part D PDP plans in NY cover Sildenafil 10 mg/12.5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:38 /1Days |
SILDENAFIL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SILDENAFIL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
SILENOR 3 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SILENOR 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
SILENOR 6 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SILENOR 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
SILVER SULFADIAZINE 1% CRM ![Compare how all Medicare Part D PDP plans in NY cover SILVER SULFADIAZINE 1% CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SIMBRINZA 1%-0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in NY cover SIMBRINZA 1%-0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIMPONI 100 MG/ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover SIMPONI 100 MG/ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SIMPONI 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover SIMPONI 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SIMPONI 50 MG/0.5 ML PEN INJEC ![Compare how all Medicare Part D PDP plans in NY cover SIMPONI 50 MG/0.5 ML PEN INJEC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SIMPONI ARIA 50 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover SIMPONI ARIA 50 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR ![Compare how all Medicare Part D PDP plans in NY cover SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SIMVASTATIN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SIMVASTATIN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SIMVASTATIN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SIMVASTATIN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SIMVASTATIN 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NY cover SIMVASTATIN 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SIMVASTATIN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SIMVASTATIN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SIMVASTATIN 80MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NY cover SIMVASTATIN 80MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:30 /30Days |
Sirolimus 0.5 MG Tablet [Rapamune] ![Compare how all Medicare Part D PDP plans in NY cover Sirolimus 0.5 MG Tablet [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIROLIMUS 1 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in NY cover SIROLIMUS 1 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
SIROLIMUS 2 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in NY cover SIROLIMUS 2 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SIRTURO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SIRTURO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:188 /168Days |
SODIUM CHLORIDE 0.45% TUBEX ![Compare how all Medicare Part D PDP plans in NY cover SODIUM CHLORIDE 0.45% TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sodium Chloride 3g/100mL ![Compare how all Medicare Part D PDP plans in NY cover Sodium Chloride 3g/100mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sodium Chloride 900mg/100mL 9 BOTTLE, PLASTIC in 1 CASE / 1500 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NY cover Sodium Chloride 900mg/100mL 9 BOTTLE, PLASTIC in 1 CASE / 1500 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sodium Chloride 9g/1000mL 4 BAG in 1 PACKAGE / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in NY cover Sodium Chloride 9g/1000mL 4 BAG in 1 PACKAGE / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SODIUM CHLORIDE INJECTION USP 5% ![Compare how all Medicare Part D PDP plans in NY cover SODIUM CHLORIDE INJECTION USP 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SODIUM CL 2.5 MEQ/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover SODIUM CL 2.5 MEQ/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SODIUM LACTATE 5 MEQ/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover SODIUM LACTATE 5 MEQ/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
sodium polystyrene sulf pwd ![Compare how all Medicare Part D PDP plans in NY cover sodium polystyrene sulf pwd.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SOLTAMOX 10 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in NY cover SOLTAMOX 10 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SOLU CORTEF INJECTION 100 MG/VIAL ![Compare how all Medicare Part D PDP plans in NY cover SOLU CORTEF INJECTION 100 MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SOMATULINE 60 MG/0.2 ML SYRING ![Compare how all Medicare Part D PDP plans in NY cover SOMATULINE 60 MG/0.2 ML SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days |
SOMATULINE DEPOT 120 MG/0.5 ML ![Compare how all Medicare Part D PDP plans in NY cover SOMATULINE DEPOT 120 MG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days |
Somatuline Depot 90mg/0.3mL 1 POUCH per CARTON / 1 SYRINGE in 1 POUCH / 0.3 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover Somatuline Depot 90mg/0.3mL 1 POUCH per CARTON / 1 SYRINGE in 1 POUCH / 0.3 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days |
SOMAVERT 10 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SOMAVERT 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SOMAVERT 15 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SOMAVERT 15 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SOMAVERT 20 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SOMAVERT 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SOMAVERT 25 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SOMAVERT 25 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SOMAVERT 30 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SOMAVERT 30 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in NY cover SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in NY cover SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in NY cover SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in NY cover SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SOTALOL HCL TABLET 240MG ![Compare how all Medicare Part D PDP plans in NY cover SOTALOL HCL TABLET 240MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sotalol Hydrochloride 120mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NY cover Sotalol Hydrochloride 120mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
sotalol hydrochloride 160mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover sotalol hydrochloride 160mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sotalol Hydrochloride 80mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NY cover Sotalol Hydrochloride 80mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SOVALDI 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SOVALDI 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:28 /28Days |
SPIRIVA 18MCG CP-HANDIHALER 90 (9 X 10) BLPK ![Compare how all Medicare Part D PDP plans in NY cover SPIRIVA 18MCG CP-HANDIHALER 90 (9 X 10) BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
SPIRIVA RESPIMAT 1.25 MCG INH ![Compare how all Medicare Part D PDP plans in NY cover SPIRIVA RESPIMAT 1.25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
SPIRIVA RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover SPIRIVA RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPIRONOLACTONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPIRONOLACTONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SPIRONOLACTONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NY cover SPIRONOLACTONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SPIRONOLACTONE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NY cover SPIRONOLACTONE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SPIRONOLACTONE/HCTZ TABLET 25-25MG (500 CT) ![Compare how all Medicare Part D PDP plans in NY cover SPIRONOLACTONE/HCTZ TABLET 25-25MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SPRINTEC 0.25-0.035 TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRINTEC 0.25-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SPRITAM 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRITAM 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:60 /30Days |
SPRITAM 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRITAM 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:120 /30Days |
SPRITAM 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRITAM 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:120 /30Days |
SPRITAM 750 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRITAM 750 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | S Q:120 /30Days |
SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPRYCEL 20MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRYCEL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:60 /30Days |
SPRYCEL 50MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRYCEL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SPRYCEL 70MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SPRYCEL 70MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SRONYX 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in NY cover SRONYX 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SSD Cream 10g/1000g 85 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NY cover SSD Cream 10g/1000g 85 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STAVUDINE 1 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in NY cover STAVUDINE 1 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STAVUDINE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in NY cover STAVUDINE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STAVUDINE CAPSULES 20MG 60 BOT ![Compare how all Medicare Part D PDP plans in NY cover STAVUDINE CAPSULES 20MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STAVUDINE CAPSULES 30MG 60 BOT ![Compare how all Medicare Part D PDP plans in NY cover STAVUDINE CAPSULES 30MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STAVUDINE CAPSULES 40MG 60 BOT ![Compare how all Medicare Part D PDP plans in NY cover STAVUDINE CAPSULES 40MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
STELARA 45 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover STELARA 45 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
STELARA 90 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover STELARA 90 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
Sterile Water 6mg/mL 1 INJECTION, SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in NY cover Sterile Water 6mg/mL 1 INJECTION, SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
STERILE WATER FOR IRRIGATION ![Compare how all Medicare Part D PDP plans in NY cover STERILE WATER FOR IRRIGATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STIOLTO RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover STIOLTO RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:4 /28Days |
STIVARGA 40 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover STIVARGA 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:84 /28Days |
STRATTERA 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
STRATTERA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
STRATTERA 18MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 18MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
STRATTERA 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
STRATTERA 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
STRATTERA 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
STRATTERA 80MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover STRATTERA 80MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
STRENSIQ 40 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover STRENSIQ 40 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
STRENSIQ 80 MG/0.8 ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover STRENSIQ 80 MG/0.8 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
STREPTOMYCIN FOR INJECTION 1GM/VIL ![Compare how all Medicare Part D PDP plans in NY cover STREPTOMYCIN FOR INJECTION 1GM/VIL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
STRIBILD TABLET ![Compare how all Medicare Part D PDP plans in NY cover STRIBILD TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
STRIVERDI RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover STRIVERDI RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
SUCRALFATE 1GM TABLET ![Compare how all Medicare Part D PDP plans in NY cover SUCRALFATE 1GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULFACETAMIDE 10% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in NY cover SULFACETAMIDE 10% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sulfacetamide Sodium 100mg/mL 118 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Sulfacetamide Sodium 100mg/mL 118 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT ![Compare how all Medicare Part D PDP plans in NY cover SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SULFACETAMIDE-PREDNISOLONE 10-0.25% DROPS ![Compare how all Medicare Part D PDP plans in NY cover SULFACETAMIDE-PREDNISOLONE 10-0.25% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sulfadiazine 500mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Sulfadiazine 500mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sulfamethoxazole and Trimethoprim 200; 40mg/5mL; mg/5mL ![Compare how all Medicare Part D PDP plans in NY cover Sulfamethoxazole and Trimethoprim 200; 40mg/5mL; mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Sulfamethoxazole and Trimethoprim 800; 160mg/1; mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Sulfamethoxazole and Trimethoprim 800; 160mg/1; mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULFAMETHOXAZOLE W/TMP VIAL 80MG-16ML 10 X 10ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover SULFAMETHOXAZOLE W/TMP VIAL 80MG-16ML 10 X 10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULFAMETHOXAZOLE-TMP SS TABLET ![Compare how all Medicare Part D PDP plans in NY cover SULFAMETHOXAZOLE-TMP SS TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULFASALAZINE 500MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SULFASALAZINE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULFAZINE EC 500MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in NY cover SULFAZINE EC 500MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULINDAC 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NY cover SULINDAC 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SULINDAC 200MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SULINDAC 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
SUMATRIPTAN 20 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover SUMATRIPTAN 20 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:12 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUMATRIPTAN 4 MG/0.5 ML CART ![Compare how all Medicare Part D PDP plans in NY cover SUMATRIPTAN 4 MG/0.5 ML CART.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:4 /28Days |
SUMATRIPTAN 5 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover SUMATRIPTAN 5 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:12 /28Days |
SUMATRIPTAN 6 MG/0.5 ML INJECT ![Compare how all Medicare Part D PDP plans in NY cover SUMATRIPTAN 6 MG/0.5 ML INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:4 /28Days |
SUMATRIPTAN 6 MG/0.5 ML REFILL ![Compare how all Medicare Part D PDP plans in NY cover SUMATRIPTAN 6 MG/0.5 ML REFILL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:4 /28Days |
Sumatriptan 6 mg/0.5 ml vial ![Compare how all Medicare Part D PDP plans in NY cover Sumatriptan 6 mg/0.5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:4 /28Days |
Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in NY cover Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:18 /28Days |
Sumatriptan Succinate 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover Sumatriptan Succinate 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:18 /28Days |
Sumatriptan Succinate 6mg/0.5mL 2 SYRINGE in 1 PACKAGE / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover Sumatriptan Succinate 6mg/0.5mL 2 SYRINGE in 1 PACKAGE / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:4 /28Days |
SUMATRIPTAN SUCCINATE TABLETS 100MG 9 BOXUD ![Compare how all Medicare Part D PDP plans in NY cover SUMATRIPTAN SUCCINATE TABLETS 100MG 9 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:18 /28Days |
SUPRAX 100 MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in NY cover SUPRAX 100 MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SUPRAX 200 MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in NY cover SUPRAX 200 MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SURMONTIL 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SURMONTIL 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
SURMONTIL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SURMONTIL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
Surmontil 50mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Surmontil 50mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
SUSTIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SUSTIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SUSTIVA 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SUSTIVA 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SUSTIVA 600MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SUSTIVA 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
SUTENT 12.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SUTENT 12.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SUTENT 25mg/1 28 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover SUTENT 25mg/1 28 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SUTENT 37.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SUTENT 37.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SUTENT 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SUTENT 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days |
SYLATRON 200 MCG KIT ![Compare how all Medicare Part D PDP plans in NY cover SYLATRON 200 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYLATRON 300 MCG KIT ![Compare how all Medicare Part D PDP plans in NY cover SYLATRON 300 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:4 /28Days |
SYLATRON 600 MCG KIT ![Compare how all Medicare Part D PDP plans in NY cover SYLATRON 600 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:4 /28Days |
SYLVANT 100 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SYLVANT 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
SYMLINPEN 120 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover SYMLINPEN 120 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:11 /28Days |
SYMLINPEN 60 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover SYMLINPEN 60 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:6 /28Days |
SYNAGIS 50MG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover SYNAGIS 50MG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SYNAREL 2MG/ML NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover SYNAREL 2MG/ML NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SYNERCID 500MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover SYNERCID 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
SYNJARDY 12.5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SYNJARDY 12.5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | S |
SYNJARDY 12.5-500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SYNJARDY 12.5-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | S |
SYNJARDY 5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SYNJARDY 5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYNJARDY 5-500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover SYNJARDY 5-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | S |
SYNRIBO 3.5 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover SYNRIBO 3.5 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:28 /28Days |
SYPRINE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover SYPRINE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |