2017 Medicare Part D Plan Formulary Information |
Humana Gold Plus H4007-012 (HMO) (H4007-012-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Humana Gold Plus H4007-012 (HMO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Humana Gold Plus H4007-012 (HMO) (H4007-012-0) Formulary Drugs Starting with the Letter A in Juncos County, PR: CMS MA Region 30 which includes: PR Plan Monthly Premium: $0.00 Deductible: $0 |
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:60 /30Days |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in PR cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ABACAVIR-LAMIVUDINE 600-300 MG [Epzicom] ![Compare how all Medicare Part D PDP plans in PR cover ABACAVIR-LAMIVUDINE 600-300 MG [Epzicom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
ABELCENT INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in PR cover ABELCENT INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ABILIFY MAINTENA ER 300 MG SYR ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 300 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 300 MG VL ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 300 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 400 MG SYR ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 400 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in PR cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ACARBOSE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACARBOSE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACARBOSE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACARBOSE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Acarbose 50mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Acarbose 50mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
ACEBUTOLOL 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover ACEBUTOLOL 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ACEBUTOLOL 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover ACEBUTOLOL 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ACELLULAR PERTUSSIS VACCINE 50 UNT/ML / DIPHTHERIA TOXOID VACCINE 50 UNT/ML / TETANUS TOXOID VACCINE ![Compare how all Medicare Part D PDP plans in PR cover ACELLULAR PERTUSSIS VACCINE 50 UNT/ML / DIPHTHERIA TOXOID VACCINE 50 UNT/ML / TETANUS TOXOID VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ACETAMINOP-CODEINE 120-12 MG/5 ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOP-CODEINE 120-12 MG/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:2700 /30Days |
ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOPHEN AND CODEINE PHOSPHATE TABLET USP 300MG-15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:390 /30Days |
ACETAMINOPHEN-COD #3 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOPHEN-COD #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:180 /30Days |
ACETASOL HC SOLUTION 10ML 10 ML BOT ![Compare how all Medicare Part D PDP plans in PR cover ACETASOL HC SOLUTION 10ML 10 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Acetazolamide 500mg/5mL 1 VIAL in 1 CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover Acetazolamide 500mg/5mL 1 VIAL in 1 CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ACETAZOLAMIDE ER CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover ACETAZOLAMIDE ER CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ACETIC ACID 2% EAR SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover ACETIC ACID 2% EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in PR cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | P |
ACETYLCYSTEINE 20% VIAL ![Compare how all Medicare Part D PDP plans in PR cover ACETYLCYSTEINE 20% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | P |
ACIPHEX 20MG TABLET EC ![Compare how all Medicare Part D PDP plans in PR cover ACIPHEX 20MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in PR cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in PR cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in PR cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ACTHIB VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in PR cover ACTHIB VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Acyclovir 200mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Acyclovir 200mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Acyclovir 200mg/5mL 473 mL BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Acyclovir 200mg/5mL 473 mL BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Acyclovir 400mg/1 ![Compare how all Medicare Part D PDP plans in PR cover Acyclovir 400mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Acyclovir 5% Ointment ![Compare how all Medicare Part D PDP plans in PR cover Acyclovir 5% Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in PR cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in PR cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ADALAT CC 30 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADALAT CC 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:60 /30Days |
Adalat CC 60mg 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Adalat CC 60mg 1000 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADALAT CC 90 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADALAT CC 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:60 /30Days |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in PR cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:6 /28Days |
ADAPALENE 0.1% GEL ![Compare how all Medicare Part D PDP plans in PR cover ADAPALENE 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ADCIRCA TABLETS 20MG 60 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover ADCIRCA TABLETS 20MG 60 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera] ![Compare how all Medicare Part D PDP plans in PR cover ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
Adriamycin 20 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in PR cover Adriamycin 20 mg/10 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:12 /30Days |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:12 /30Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:12 /30Days |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in PR cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in PR cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
AFINITOR TABLETS 2.5 MG ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR TABLETS 2.5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | S |
ALA-CORT 1% CREAM ![Compare how all Medicare Part D PDP plans in PR cover ALA-CORT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Ala-cort 2.5% cream ![Compare how all Medicare Part D PDP plans in PR cover Ala-cort 2.5% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ALBENZA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALBENZA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | P |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | P |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | P |
ALBUTEROL SULFATE SOLUTION FOR INHALATION ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE SOLUTION FOR INHALATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | P |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ALBUTEROL SULFATE TABLET 2MG (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULFATE TABLET 2MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ALBUTEROL TABLET 4MG (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL TABLET 4MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ALCLOMETASONE DIPROPIONATE 0.05% CREAM ![Compare how all Medicare Part D PDP plans in PR cover ALCLOMETASONE DIPROPIONATE 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Alclometasone Dipropionate 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PR cover Alclometasone Dipropionate 0.5mg/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 | $101.00 | None |
ALECENSA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover ALECENSA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:240 /30Days |
ALENDRONATE SODIUM 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ALENDRONATE SODIUM 35 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ALENDRONATE SODIUM 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ALENDRONATE SODIUM 70 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 70 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:4 /28Days |
ALFUZOSIN HYDROCHLORIDE 10mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover ALFUZOSIN HYDROCHLORIDE 10mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:30 /30Days |
ALIMTA 500MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ALIMTA 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ALINIA 100 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover ALINIA 100 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:150 /30Days |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:40 /30Days |
Aliskiren 150 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in PR cover Aliskiren 150 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:30 /30Days |
Aliskiren 150 MG / Hydrochlorothiazide 25 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in PR cover Aliskiren 150 MG / Hydrochlorothiazide 25 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:30 /30Days |
Aliskiren 300 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in PR cover Aliskiren 300 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:30 /30Days |
ALKERAN 50 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ALKERAN 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALLOPURINOL 100 MG TABLETS ![Compare how all Medicare Part D PDP plans in PR cover ALLOPURINOL 100 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Allopurinol 300mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Allopurinol sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in PR cover Allopurinol sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ALOPRIM SOLUTION FOR INJECTION 500MG/VIAL 30 ML VIALGL ![Compare how all Medicare Part D PDP plans in PR cover ALOPRIM SOLUTION FOR INJECTION 500MG/VIAL 30 ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ALORA 0.025 MG PATCH ![Compare how all Medicare Part D PDP plans in PR cover ALORA 0.025 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:8 /28Days |
ALORA 0.05 MG PATCH ![Compare how all Medicare Part D PDP plans in PR cover ALORA 0.05 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:8 /28Days |
ALORA 0.075 MG PATCH ![Compare how all Medicare Part D PDP plans in PR cover ALORA 0.075 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:8 /28Days |
ALORA 0.1 MG PATCH ![Compare how all Medicare Part D PDP plans in PR cover ALORA 0.1 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:8 /28Days |
ALOSETRON HCL 0.5 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in PR cover ALOSETRON HCL 0.5 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ALOSETRON HCL 1 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in PR cover ALOSETRON HCL 1 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in PR cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALPHAGAN P 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover ALPHAGAN P 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
ALPRAZOLAM 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:120 /30Days |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:120 /30Days |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:120 /30Days |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:150 /30Days |
ALUNBRIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALUNBRIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:180 /30Days |
Alyacen 1-35-28 tablet ![Compare how all Medicare Part D PDP plans in PR cover Alyacen 1-35-28 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Amabelz 0.5 mg-0.1 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover Amabelz 0.5 mg-0.1 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Amabelz 1 mg-0.5 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover Amabelz 1 mg-0.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMANTADINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMANTADINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMANTADINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMANTADINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amantadine Hydrochloride 50mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Amantadine Hydrochloride 50mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AMBIEN CR 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMBIEN CR 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AMBIEN CR 6.25MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMBIEN CR 6.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AMBISOME 50MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMBISOME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Amethia 0.15-0.03-0.01 mg tab ![Compare how all Medicare Part D PDP plans in PR cover Amethia 0.15-0.03-0.01 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Amethia lo tablet ![Compare how all Medicare Part D PDP plans in PR cover Amethia lo tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:91 /90Days |
AMIKACIN SULFATE 500 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMIKACIN SULFATE 500 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMILORIDE HCL W/HCTZ 5MG-50MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMILORIDE HCL W/HCTZ 5MG-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover AMILORIDE HYDROCHLORIDE TABLETS 5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Amino Acids 15% Solution ![Compare how all Medicare Part D PDP plans in PR cover Amino Acids 15% Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Aminophylline 25mg/mL 5 TRAY per CARTON / 5 AMPULE in 1 TRAY / 10 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in PR cover Aminophylline 25mg/mL 5 TRAY per CARTON / 5 AMPULE in 1 TRAY / 10 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN 7%-ELECTROLYTE SOL ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN 7%-ELECTROLYTE SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN HBC INJECTION SULFITE FREE 7% ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN HBC INJECTION SULFITE FREE 7%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN II 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN II 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AMINOSYN-RF 5.2% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN-RF 5.2% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Amiodarone 150 mg/3 ml ampule ![Compare how all Medicare Part D PDP plans in PR cover Amiodarone 150 mg/3 ml ampule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amiodarone hcl 100 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover Amiodarone hcl 100 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMIODARONE HCL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMIODARONE HCL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMIODARONE HCL 400MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMIODARONE HCL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in PR cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
AMITRIP/PERPHEN 10-2 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIP/PERPHEN 10-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMITRIP/PERPHEN 25-2 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIP/PERPHEN 25-2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMITRIP/PERPHEN 25-4 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIP/PERPHEN 25-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMITRIPTYLINE HCL 100MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AMITRIPTYLINE HCL 150 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 150 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AMITRIPTYLINE HCL 25MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 25MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AMITRIPTYLINE HCL 75MG TABLET USP (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 75MG TABLET USP (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AMITRIPTYLINE HCL TABLETS 50MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL TABLETS 50MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AMLODIPINE BESYLATE 10MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE 10MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE 2.5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMLODIPINE BESYLATE 5MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE 5MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:60 /30Days |
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:60 /30Days |
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:60 /30Days |
Amlodipine-Atorvastatin 10-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 10-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 10-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 10-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 10-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 10-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 10-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 10-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 2.5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 2.5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 2.5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 2.5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 2.5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 2.5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Atorvastatin 5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amlodipine-Atorvastatin 5-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
AMLODIPINE-BENAZEPRIL 10-40 MG ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 10-40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:30 /30Days |
AMLODIPINE-BENAZEPRIL 5-40 MG ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 5-40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | Q:30 /30Days |
AMLODIPINE-OLMESARTAN 5-40 MG [Azor] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-OLMESARTAN 5-40 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Olmesartan medoxomil 10 MG / 20 MG Oral Tablet [Azor] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Olmesartan medoxomil 10 MG / 20 MG Oral Tablet [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Olmesartan medoxomil 10 MG / 40 MG Oral Tablet [Azor] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Olmesartan medoxomil 10 MG / 40 MG Oral Tablet [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Amlodipine-Olmesartan medoxomil 5 MG / 20 MG Oral Tablet [Azor] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Olmesartan medoxomil 5 MG / 20 MG Oral Tablet [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
AMLODIPINE-VALSARTAN 10-160 MG ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-VALSARTAN 10-160 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
AMLODIPINE-VALSARTAN 10-320 MG ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-VALSARTAN 10-320 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
AMLODIPINE-VALSARTAN 5-160 MG ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-VALSARTAN 5-160 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
AMLODIPINE-VALSARTAN 5-320 MG ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-VALSARTAN 5-320 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMMONIUM LACTATE 12% CREAM ![Compare how all Medicare Part D PDP plans in PR cover AMMONIUM LACTATE 12% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in PR cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOX TR-K CLV 500-125 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-K CLV 500-125 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG/5 SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOX-CLAV 200-28.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 200-28.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN 250MG 500 CHEWABLE TABLET in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 250MG 500 CHEWABLE TABLET in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN 50 MG/ML / CLAVULANATE 12.5 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 50 MG/ML / CLAVULANATE 12.5 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOXICILLIN 500MG 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 500MG 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN 500MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 500MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN 875MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 875MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS 875;125MG;MG 20 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS EXTENDED RELEASE 1000;62.5MG;MG ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN AND CLAVULANATE POTASSIUM TABLETS EXTENDED RELEASE 1000;62.5MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN CLAVULANATE POTASSIUM FOR SUSPENSION 600-42.9MG 125ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN FOR ORAL SUSPENSION 125MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN FOR ORAL SUSPENSION 200MG/5ML 100ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN FOR ORAL SUSPENSION 250MG/5ML 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN FOR ORAL SUSPENSION 400MG/5ML 50ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:90 /30Days |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:90 /30Days |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:90 /30Days |
AMPHETAMINE SALTS 5 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALTS 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:90 /30Days |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in PR cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMPICILLIN CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMPICILLIN FOR INJECTION POWDER ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN FOR INJECTION POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN FOR ORAL SUSPENSION 125MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN FOR ORAL SUSPENSION 250MG 100ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AMPICILLIN POWDER FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN POWDER FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ampicillin-sulbactam 1.5 gm vl ![Compare how all Medicare Part D PDP plans in PR cover ampicillin-sulbactam 1.5 gm vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMPICILLIN-SULBACTAM 15 GM VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN-SULBACTAM 15 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMPICILLIN-SULBACTAM 3 GM VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN-SULBACTAM 3 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AMPYRA ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPYRA ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
ANADROL-50 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ANADROL-50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Anastrozole 1mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Anastrozole 1mg/1 90 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ANDROGEL 1.62% (1.25G) GEL PCKT ![Compare how all Medicare Part D PDP plans in PR cover ANDROGEL 1.62% (1.25G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:38 /30Days |
ANDROGEL 1.62% (2.5G) GEL PCKT ![Compare how all Medicare Part D PDP plans in PR cover ANDROGEL 1.62% (2.5G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:150 /30Days |
Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in PR cover Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:150 /30Days |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in PR cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:60 /30Days |
ANUSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in PR cover ANUSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in PR cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /28Days |
Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER per CARTON / 10 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in PR cover Apraclonidine Ophthalmic 5mg/mL 1 BOTTLE, DROPPER per CARTON / 10 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
APREPITANT 125 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 125 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:2 /28Days |
APREPITANT 125-80-80 MG PACK [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 125-80-80 MG PACK [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:6 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APREPITANT 40 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 40 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:2 /28Days |
APREPITANT 80 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 80 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:4 /28Days |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in PR cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
APRISO CP24 ![Compare how all Medicare Part D PDP plans in PR cover APRISO CP24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:120 /30Days |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:60 /30Days |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:120 /30Days |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in PR cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:285 /28Days |
ARALAST NP 500 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARALAST NP 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Argatroban 2.5 ML 100 MG/ML Injection ![Compare how all Medicare Part D PDP plans in PR cover Argatroban 2.5 ML 100 MG/ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /30Days |
ARIPIPRAZOLE ODT 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE ODT 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ARIPIPRAZOLE ODT 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE ODT 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARISTADA ER 1064 MG/3.9 ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ARISTADA ER 1064 MG/3.9 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:4 /56Days |
ARISTADA ER 441 MG/1.6 ML SYRN ![Compare how all Medicare Part D PDP plans in PR cover ARISTADA ER 441 MG/1.6 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:2 /28Days |
ARISTADA ER 662 MG/2.4 ML SYRN ![Compare how all Medicare Part D PDP plans in PR cover ARISTADA ER 662 MG/2.4 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:2 /28Days |
ARISTADA ER 882 MG/3.2 ML SYRN ![Compare how all Medicare Part D PDP plans in PR cover ARISTADA ER 882 MG/3.2 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:3 /28Days |
Armodafinil 150 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in PR cover Armodafinil 150 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
Armodafinil 200 MG Oral Tablet [NUVIGIL] ![Compare how all Medicare Part D PDP plans in PR cover Armodafinil 200 MG Oral Tablet [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
Armodafinil 250 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in PR cover Armodafinil 250 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
Armodafinil 50 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in PR cover Armodafinil 50 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:60 /30Days |
ARNUITY ELLIPTA 100 MCG INH ![Compare how all Medicare Part D PDP plans in PR cover ARNUITY ELLIPTA 100 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:30 /30Days |
ARNUITY ELLIPTA 200 MCG INH ![Compare how all Medicare Part D PDP plans in PR cover ARNUITY ELLIPTA 200 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:30 /30Days |
ARRANON 250 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARRANON 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARTHROTEC 50 50MG TABLET -200MCG (60 CT) ![Compare how all Medicare Part D PDP plans in PR cover ARTHROTEC 50 50MG TABLET -200MCG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
ARTHROTEC 75 TABLET EC ![Compare how all Medicare Part D PDP plans in PR cover ARTHROTEC 75 TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Ashlyna 0.15-0.03-0.01 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover Ashlyna 0.15-0.03-0.01 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Aspirin-Diphenhydramine ER 25-200 MG ![Compare how all Medicare Part D PDP plans in PR cover Aspirin-Diphenhydramine ER 25-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | S |
ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE ![Compare how all Medicare Part D PDP plans in PR cover ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:180 /30Days |
Atelvia 35mg/1 36 DOSE PACK CASE / 4 TABLET, DELAYED RELEASE in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in PR cover Atelvia 35mg/1 36 DOSE PACK CASE / 4 TABLET, DELAYED RELEASE in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:4 /28Days |
ATENOLOL 100 MG100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL 100 MG100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
ATENOLOL 25 MG 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL 25 MG 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
ATENOLOL TABLET USP 50MG (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL TABLET USP 50MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATGAM 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in PR cover ATGAM 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
Atomoxetine 10 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 10 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:60 /30Days |
Atomoxetine 100 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 100 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
Atomoxetine 18 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 18 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:60 /30Days |
Atomoxetine 25 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 25 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:60 /30Days |
Atomoxetine 40 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 40 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:60 /30Days |
Atomoxetine 60 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 60 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
Atomoxetine 80 MG Oral Capsule [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover Atomoxetine 80 MG Oral Capsule [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in PR cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in PR cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Atovaquone-Proguanil 62.5-25 [Malarone] ![Compare how all Medicare Part D PDP plans in PR cover Atovaquone-Proguanil 62.5-25 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
Atropine 1% Eye Drops ![Compare how all Medicare Part D PDP plans in PR cover Atropine 1% Eye Drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in PR cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:26 /30Days |
AUBRA-28 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AUBRA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AURYXIA 210 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AURYXIA 210 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:360 /30Days |
AVANDIA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AVANDIA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:60 /30Days |
AVANDIA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AVANDIA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AVASTIN 400 MG/16 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover AVASTIN 400 MG/16 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AVELOX 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AVELOX 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P |
AVELOX IV 400 MG/250 ML ![Compare how all Medicare Part D PDP plans in PR cover AVELOX IV 400 MG/250 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in PR cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
AVODART 0.5MG SOFTGEL ![Compare how all Medicare Part D PDP plans in PR cover AVODART 0.5MG SOFTGEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AVONEX ADMIN PACK 30 MCG VL ![Compare how all Medicare Part D PDP plans in PR cover AVONEX ADMIN PACK 30 MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:4 /28Days |
AVONEX PEN 30 MCG/0.5 ML KIT ![Compare how all Medicare Part D PDP plans in PR cover AVONEX PEN 30 MCG/0.5 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:1 /28Days |
AVONEX PREFILLED SYR 30 MCG KT ![Compare how all Medicare Part D PDP plans in PR cover AVONEX PREFILLED SYR 30 MCG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:1 /28Days |
Aygestin 5mg/1 50 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Aygestin 5mg/1 50 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |
Azacitidine 100 mg vial [Vidaza] ![Compare how all Medicare Part D PDP plans in PR cover Azacitidine 100 mg vial [Vidaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZASITE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover AZASITE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZATHIOPRINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZATHIOPRINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | P |
AZELASTINE 0.15% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in PR cover AZELASTINE 0.15% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | Q:30 /25Days |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in PR cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | Q:30 /25Days |
AZELASTINE HYDROCHLORIDE OPHTHALMIC SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AZELASTINE HYDROCHLORIDE OPHTHALMIC SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZILECT 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZILECT 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZILECT 1MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZILECT 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZITHROMYCIN 1 GM PWD PACKET ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 1 GM PWD PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZITHROMYCIN 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
Azithromycin 200mg/5mL 22.5 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Azithromycin 200mg/5mL 22.5 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Azithromycin 500 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover Azithromycin 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Azithromycin 500mg/1 10 VIAL, SINGLE-USE in 1 TRAY / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover Azithromycin 500mg/1 10 VIAL, SINGLE-USE in 1 TRAY / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
Azithromycin 600mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Azithromycin 600mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$9.00 | $0.00 | None |
AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT ![Compare how all Medicare Part D PDP plans in PR cover AZOPT SUSPENSION OPHTHALMIC 1% 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | $101.00 | None |
AZOR 10-20 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZOR 10-20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AZOR 10MG-40MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in PR cover AZOR 10MG-40MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AZOR 5-40 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZOR 5-40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AZOR 5MG-20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in PR cover AZOR 5MG-20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | P Q:30 /30Days |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$82.00 | $236.00 | None |