2017 Medicare Part D Plan Formulary Information |
Peoples Health Choices 65 #14 (HMO) (H1961-014-1)
Benefit Details
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The Peoples Health Choices 65 #14 (HMO) (H1961-014-1) Formulary Drugs Starting with the Letter E in Terrebonne Parish, LA: CMS MA Region 16 which includes: LA Plan Monthly Premium: $0.00 Deductible: $0 |
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
E.E.S. 400 FILMTAB ![Compare how all Medicare Part D PDP plans in LA cover E.E.S. 400 FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
E.E.S. GRAN SUS 200/5ML ![Compare how all Medicare Part D PDP plans in LA cover E.E.S. GRAN SUS 200/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in LA cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EFFIENT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EFFIENT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EFFIENT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EFFIENT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EGRIFTA 2 MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover EGRIFTA 2 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in LA cover ELAPRASE 6mg/3mL 1 VIAL, GLASS in 1 BOX / 3 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ELELYSO 200 UNITS VIAL ![Compare how all Medicare Part D PDP plans in LA cover ELELYSO 200 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ELIDEL 1% CREAM ![Compare how all Medicare Part D PDP plans in LA cover ELIDEL 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIGARD 22.5 MG SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ELIGARD 22.5 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ELIGARD 30 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in LA cover ELIGARD 30 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ELIGARD 45 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in LA cover ELIGARD 45 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ELIGARD 7.5 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in LA cover ELIGARD 7.5 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ELIQUIS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ELIQUIS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ELIQUIS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ELIQUIS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
Elitek 3 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in LA cover Elitek 3 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ELITEK 7.5 MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover ELITEK 7.5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
EMADINE 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in LA cover EMADINE 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMEND 125 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in LA cover EMEND 125 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EMEND 150 MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover EMEND 150 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
EMEND 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover EMEND 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EMEND CAPSULES 125MG 6 BLPK ![Compare how all Medicare Part D PDP plans in LA cover EMEND CAPSULES 125MG 6 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EMEND CAPSULES 80MG 2 BLPK ![Compare how all Medicare Part D PDP plans in LA cover EMEND CAPSULES 80MG 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EMEND TRIFOLD PACK ![Compare how all Medicare Part D PDP plans in LA cover EMEND TRIFOLD PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
Emoquette 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in LA cover Emoquette 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EMPLICITI 300 MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover EMPLICITI 300 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
EMPLICITI 400 MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover EMPLICITI 400 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in LA cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in LA cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in LA cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ENALAPRIL MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover ENALAPRIL MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
ENALAPRIL MALEATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in LA cover ENALAPRIL MALEATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in LA cover Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in LA cover Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:270 /30Days |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:270 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:270 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in LA cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ENGERIX-B 10MCG 10 X 0.5ML VIALSD ![Compare how all Medicare Part D PDP plans in LA cover ENGERIX-B 10MCG 10 X 0.5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ENGERIX-B 20 MCG/ML SYRN ![Compare how all Medicare Part D PDP plans in LA cover ENGERIX-B 20 MCG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ENOXAPARIN 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ENOXAPARIN 120 MG/0.8 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 120 MG/0.8 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ENOXAPARIN 150 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 150 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ENOXAPARIN 30 MG/0.3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 30 MG/0.3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENOXAPARIN 300 MG/3 ML vial ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 300 MG/3 ML vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENOXAPARIN 40 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 40 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENOXAPARIN 60 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 60 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENOXAPARIN 80 MG/0.8 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover ENOXAPARIN 80 MG/0.8 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENTACAPONE 200 MG TABLET [Comtan Entacapone] ![Compare how all Medicare Part D PDP plans in LA cover ENTACAPONE 200 MG TABLET [Comtan Entacapone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:240 /30Days |
ENTECAVIR 0.5 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in LA cover ENTECAVIR 0.5 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENTECAVIR 1 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in LA cover ENTECAVIR 1 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENTRESTO 24 MG-26 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENTRESTO 24 MG-26 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ENTRESTO 49 MG-51 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENTRESTO 49 MG-51 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ENTRESTO 97 MG-103 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENTRESTO 97 MG-103 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ENVARSUS XR 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENVARSUS XR 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ENVARSUS XR 1 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENVARSUS XR 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ENVARSUS XR 4 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ENVARSUS XR 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPINASTINE HCL 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in LA cover EPINASTINE HCL 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EPINEPHRINE 0.15 MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in LA cover EPINEPHRINE 0.15 MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EPINEPHRINE 0.3 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in LA cover EPINEPHRINE 0.3 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EPINEPHRINE 0.3 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in LA cover EPINEPHRINE 0.3 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EPIPEN 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in LA cover EPIPEN 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
EPIPEN JR 0.15MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in LA cover EPIPEN JR 0.15MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
Epirubicin 200 mg/100 ml vial ![Compare how all Medicare Part D PDP plans in LA cover Epirubicin 200 mg/100 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | P |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in LA cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
Eplerenone 25mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Eplerenone 25mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | P |
Eplerenone 50mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Eplerenone 50mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in LA cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in LA cover EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EPOGEN 3000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in LA cover EPOGEN 3000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in LA cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in LA cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
EPZICOM 600MG/300MG TABLETS ![Compare how all Medicare Part D PDP plans in LA cover EPZICOM 600MG/300MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
EQUETRO CAPSULES 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in LA cover EQUETRO CAPSULES 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EQUETRO CAPSULES 300MG 120 BOT ![Compare how all Medicare Part D PDP plans in LA cover EQUETRO CAPSULES 300MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT ![Compare how all Medicare Part D PDP plans in LA cover EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in LA cover ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ERAXIS(WATER DIL) 50 MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover ERAXIS(WATER DIL) 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERBITUX 100MG/50ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover ERBITUX 100MG/50ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ERGOLOID MESYLATES TABLETS 1MG 100 BOT ![Compare how all Medicare Part D PDP plans in LA cover ERGOLOID MESYLATES TABLETS 1MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | P |
Ergotamine-caffeine 1-100mg tb ![Compare how all Medicare Part D PDP plans in LA cover Ergotamine-caffeine 1-100mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:40 /30Days |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
Errin 0.35 mg tablet ![Compare how all Medicare Part D PDP plans in LA cover Errin 0.35 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERTACZO 2% CREAM ![Compare how all Medicare Part D PDP plans in LA cover ERTACZO 2% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ERWINAZE 10,000 UNITS VIAL ![Compare how all Medicare Part D PDP plans in LA cover ERWINAZE 10,000 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in LA cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERY-TAB TAB 250MG EC ![Compare how all Medicare Part D PDP plans in LA cover ERY-TAB TAB 250MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERY-TAB TAB 333MG EC ![Compare how all Medicare Part D PDP plans in LA cover ERY-TAB TAB 333MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYPED 200 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in LA cover ERYPED 200 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ERYPED 400 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in LA cover ERYPED 400 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERYTHROCIN TAB 250MG ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROCIN TAB 250MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Erythromycin 2% solution ![Compare how all Medicare Part D PDP plans in LA cover Erythromycin 2% solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in LA cover Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ERYTHROMYCIN 500 MG FILMTAB ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROMYCIN 500 MG FILMTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ERYTHROMYCIN EC 250 MG CAP ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROMYCIN EC 250 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERYTHROMYCIN ES 400 MG TAB ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROMYCIN ES 400 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Erythromycin Ethylsuccinate 40 MG/ML Oral Suspension ![Compare how all Medicare Part D PDP plans in LA cover Erythromycin Ethylsuccinate 40 MG/ML Oral Suspension.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN TAB 250MG BS ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROMYCIN TAB 250MG BS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL ![Compare how all Medicare Part D PDP plans in LA cover ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ESBRIET 267 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover ESBRIET 267 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ESBRIET 267 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESBRIET 267 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ESBRIET 801 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESBRIET 801 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in LA cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in LA cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in LA cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro] ![Compare how all Medicare Part D PDP plans in LA cover ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESOMEPRAZOLE DR 49.3 MG CAPSULE [Nexium] ![Compare how all Medicare Part D PDP plans in LA cover ESOMEPRAZOLE DR 49.3 MG CAPSULE [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | Q:30 /30Days |
ESOMEPRAZOLE MAG DR 20 MG CAPSULE [Nexium] ![Compare how all Medicare Part D PDP plans in LA cover ESOMEPRAZOLE MAG DR 20 MG CAPSULE [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium] ![Compare how all Medicare Part D PDP plans in LA cover ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium] ![Compare how all Medicare Part D PDP plans in LA cover ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESTRACE VAG CREAM 0.1MG/GM ![Compare how all Medicare Part D PDP plans in LA cover ESTRACE VAG CREAM 0.1MG/GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ESTRADIOL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL TABLET 1MG (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TABLET 1MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL TDS 0.025 MG/DAY ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TDS 0.025 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL TDS 0.0375 MG/DAY ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TDS 0.0375 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL TDS 0.05 MG/DAY ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TDS 0.05 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL TDS 0.06 MG/DAY ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TDS 0.06 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL TDS 0.075 MG/DAY ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TDS 0.075 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL TDS 0.1 MG/DAY ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL TDS 0.1 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in LA cover ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in LA cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $111.00 | None |
ESTROPIPATE 0.625(0.75 MG) TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESTROPIPATE 0.625(0.75 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTROPIPATE 1.25(1.5 MG) TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESTROPIPATE 1.25(1.5 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESTROPIPATE 2.5(3 MG) TABLET ![Compare how all Medicare Part D PDP plans in LA cover ESTROPIPATE 2.5(3 MG) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESZOPICLONE 1 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in LA cover ESZOPICLONE 1 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESZOPICLONE 2 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in LA cover ESZOPICLONE 2 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ESZOPICLONE 3 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in LA cover ESZOPICLONE 3 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
ETHACRYNATE SODIUM 50 MG VIAL [Sodium Edecrin] ![Compare how all Medicare Part D PDP plans in LA cover ETHACRYNATE SODIUM 50 MG VIAL [Sodium Edecrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in LA cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21 ![Compare how all Medicare Part D PDP plans in LA cover ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETHOSUXIMIDE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover ETHOSUXIMIDE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETHOSUXIMIDE 250MG/5ML SYRP ![Compare how all Medicare Part D PDP plans in LA cover ETHOSUXIMIDE 250MG/5ML SYRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ethynodiol-eth estra 1mg-50mcg [ZOVIA] ![Compare how all Medicare Part D PDP plans in LA cover ethynodiol-eth estra 1mg-50mcg [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETIDRONATE DISODIUM 400MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in LA cover ETIDRONATE DISODIUM 400MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETIDRONATE DISODIUM TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in LA cover ETIDRONATE DISODIUM TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETODOLAC 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover ETODOLAC 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Etodolac 300 mg capsule ![Compare how all Medicare Part D PDP plans in LA cover Etodolac 300 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETODOLAC 400 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ETODOLAC 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETODOLAC 400MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in LA cover ETODOLAC 400MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETODOLAC 500 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ETODOLAC 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETODOLAC 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in LA cover ETODOLAC 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETODOLAC 600MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in LA cover ETODOLAC 600MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ETOPOPHOS 100MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover ETOPOPHOS 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | P |
Etoposide 500 mg/25 ml vial ![Compare how all Medicare Part D PDP plans in LA cover Etoposide 500 mg/25 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | P |
Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in LA cover Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
EVOTAZ 300 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EVOTAZ 300 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Exelderm 10mg/g 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in LA cover Exelderm 10mg/g 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Exelderm 10mg/mL 30 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in LA cover Exelderm 10mg/mL 30 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
EXTAVIA 15 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in LA cover EXTAVIA 15 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Ezetimibe 10 mg tablet [Zetia] ![Compare how all Medicare Part D PDP plans in LA cover Ezetimibe 10 mg tablet [Zetia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$80.00 | $240.00 | None |