2017 Medicare Part D Plan Formulary Information |
Anthem MediBlue Access (PPO) (H4036-008-0)
Benefit Details
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The Anthem MediBlue Access (PPO) (H4036-008-0) Formulary Drugs Starting with the Letter R in Sheboygan County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $40.00 Deductible: $0 |
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
RABAVERT RABIES VACCINE VIAL ![Compare how all Medicare Part D PDP plans in WI cover RABAVERT RABIES VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
Raloxifene HCl 60 mg tablet [Evista] ![Compare how all Medicare Part D PDP plans in WI cover Raloxifene HCl 60 mg tablet [Evista].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:30 /30Days |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
RANEXA ER 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RANEXA ER 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | S |
RANEXA ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RANEXA ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | S |
Ranitidine 15 mg/ml syrup ![Compare how all Medicare Part D PDP plans in WI cover Ranitidine 15 mg/ml syrup.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
RANITIDINE HCL 50 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RANITIDINE HCL 50 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
Ranitidine Hydrochloride 150mg/1 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Ranitidine Hydrochloride 150mg/1 1000 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in WI cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Rasagiline Mesylate 0.5 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in WI cover Rasagiline Mesylate 0.5 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
Rasagiline Mesylate 1 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in WI cover Rasagiline Mesylate 1 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
RAVICTI 1.1 GRAM/ML LIQUID ![Compare how all Medicare Part D PDP plans in WI cover RAVICTI 1.1 GRAM/ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:525 /30Days |
RAZADYNE 4MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RAZADYNE 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](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 |
REBIF REBIDOSE 22 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE 22 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REBIF REBIDOSE 44 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE 44 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REBIF REBIDOSE TITRATION PACK ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE TITRATION PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in WI cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in WI cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
RECOMBIVAX HB 10 MCG/ML SYR ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 10 MCG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | P |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | P |
RECOMBIVAX HB 5 MCG/0.5 ML SYR ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 5 MCG/0.5 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | P |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in WI cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:60 /180Days |
RELISTOR 12 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 12 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RELISTOR 12 MG/0.6 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 12 MG/0.6 ML 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 |
RELISTOR 8 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 8 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover REMICADE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REMODULIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover REMODULIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REMODULIN 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover REMODULIN 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REMODULIN 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover REMODULIN 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
REMODULIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:540 /30Days |
Repaglinide 0.5 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover Repaglinide 0.5 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:960 /30Days |
Repaglinide 1 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover Repaglinide 1 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:480 /30Days |
Repaglinide 2 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover Repaglinide 2 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:240 /30Days |
REPATHA 140 MG/ML SURECLICK ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 140 MG/ML SURECLICK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:3 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REPATHA 140 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 140 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:3 /28Days |
REPATHA 420 MG/3.5ML PUSHTRONX ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 420 MG/3.5ML PUSHTRONX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:4 /28Days |
REQUIP 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REQUIP 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
REQUIP 4MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REQUIP 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
REQUIP 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REQUIP 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RESCRIPTOR 100mg/1 360 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RESCRIPTOR 100mg/1 360 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:360 /30Days |
RESCRIPTOR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RESCRIPTOR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:180 /30Days |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in WI cover RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
RETROVIR 200 MG/20 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETROVIR 200 MG/20 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
REVLIMID 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVLIMID 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
REVLIMID 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
REVLIMID 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
REVLIMID 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:150 /30Days |
REXULTI 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
REXULTI 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
REXULTI 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
REXULTI 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
REXULTI 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
REXULTI 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 150MG CAPSULE.](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 |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
REYATAZ 50 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 50 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:240 /30Days |
RIBASPHERE 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIBASPHERE 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIBAVIRIN 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIBAVIRIN 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in WI cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
RIDAURA 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIDAURA 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIFABUTIN 150 MG CAPSULE [Mycobutin] ![Compare how all Medicare Part D PDP plans in WI cover RIFABUTIN 150 MG CAPSULE [Mycobutin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Rifampin IV 600 MG Vial ![Compare how all Medicare Part D PDP plans in WI cover Rifampin IV 600 MG Vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIFATER 50/300/120 TABLET ![Compare how all Medicare Part D PDP plans in WI cover RIFATER 50/300/120 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
riluzole 50 mg tablet [Rilutek] ![Compare how all Medicare Part D PDP plans in WI cover riluzole 50 mg tablet [Rilutek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
Rimantadine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Rimantadine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
RINGERS 33/30/860 INJECTION ![Compare how all Medicare Part D PDP plans in WI cover RINGERS 33/30/860 INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in WI cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in WI cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:780 /30Days |
RISEDRONATE SODIUM 150 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 150 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | S Q:1 /28Days |
RISEDRONATE SODIUM 30 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 30 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | S Q:30 /30Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | S Q:4 /28Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | S Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | S Q:4 /28Days |
RISEDRONATE SODIUM 5 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 5 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | S Q:30 /30Days |
RISEDRONATE SODIUM DR 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM DR 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:4 /28Days |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:2 /28Days |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:2 /28Days |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:2 /28Days |
RISPERIDONE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | Q:1920 /30Days |
RISPERIDONE 0.5 MG 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.5 MG 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | Q:960 /30Days |
RISPERIDONE 0.5 MG ODT ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.5 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:960 /30Days |
RISPERIDONE 1 MG 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:480 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | Q:480 /30Days |
RISPERIDONE 1 MG/ML 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG/ML 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:480 /30Days |
RISPERIDONE 2 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 2 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | Q:240 /30Days |
RISPERIDONE 2 MG ODT ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 2 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:240 /30Days |
RISPERIDONE 3 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 3 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | Q:150 /30Days |
RISPERIDONE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | Q:120 /30Days |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:1920 /30Days |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:150 /30Days |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:120 /30Days |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RITUXAN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RIVASTIGMINE 13.3 MG/24HR PTCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 13.3 MG/24HR PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIVASTIGMINE 4.6 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 4.6 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:30 /30Days |
RIVASTIGMINE 9.5 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 9.5 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:30 /30Days |
RIVASTIGMINE TARTRATE 3MG CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE TARTRATE 3MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:60 /30Days |
RIVASTIGMINE TARTRATE 4.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE TARTRATE 4.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:60 /30Days |
RIVASTIGMINE TARTRATE 6MG CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE TARTRATE 6MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:60 /30Days |
RIVASTIGMINE TARTRATE1.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE TARTRATE1.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:60 /30Days |
Rizatriptan 10 mg odt ![Compare how all Medicare Part D PDP plans in WI cover Rizatriptan 10 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:12 /30Days |
Rizatriptan 10 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover Rizatriptan 10 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:12 /30Days |
Rizatriptan 5 mg odt ![Compare how all Medicare Part D PDP plans in WI cover Rizatriptan 5 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:12 /30Days |
Rizatriptan 5 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover Rizatriptan 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | Q:12 /30Days |
ROPINIROLE HCL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROPINIROLE HYDROCLORIDE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HYDROCLORIDE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROPINIROLE TAB 12MG ER ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE TAB 12MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
ROPINIROLE TAB 2MG ER ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE TAB 2MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
ROPINIROLE TAB 4MG ER ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE TAB 4MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
ROPINIROLE TAB 6MG ER ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE TAB 6MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
ROPINIROLE TAB 8MG ER ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE TAB 8MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$93.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:30 /30Days |
ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:30 /30Days |
Rosuvastatin calcium 40 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover Rosuvastatin calcium 40 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:30 /30Days |
ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:30 /30Days |
ROTARIX VACCINE SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover ROTARIX VACCINE SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in WI cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | None |
Roweepra 500 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover Roweepra 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | N/A | None |
ROZEREM 8MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover ROZEREM 8MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | N/A | Q:30 /30Days |
RUBRACA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:180 /30Days |
RUBRACA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
RYDAPT 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RYDAPT 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:240 /30Days |