2017 Medicare Part D Plan Formulary Information |
AAA1 Vantage PREMIUM (HMO-POS) (H5576-018-2)
Benefit Details
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The AAA1 Vantage PREMIUM (HMO-POS) (H5576-018-2) Formulary Drugs Starting with the Letter R in Union Parish, LA: CMS MA Region 16 which includes: LA Plan Monthly Premium: $151.00 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 LA cover RABAVERT RABIES VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
Rabeprazole Sodium DR 20 MG Tablet [AcipHex] ![Compare how all Medicare Part D PDP plans in LA cover Rabeprazole Sodium DR 20 MG Tablet [AcipHex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Raloxifene HCl 60 mg tablet [Evista] ![Compare how all Medicare Part D PDP plans in LA cover Raloxifene HCl 60 mg tablet [Evista].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RANEXA ER 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RANEXA ER 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
RANEXA ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RANEXA ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Ranitidine 15 mg/ml syrup ![Compare how all Medicare Part D PDP plans in LA cover Ranitidine 15 mg/ml syrup.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RANITIDINE HCL 50 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover RANITIDINE HCL 50 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Ranitidine Hydrochloride 150mg/1 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in LA 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 |
$4.00 | $0.00 | None |
Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RAPAFLO CAPSULES 4MG 30 BOT ![Compare how all Medicare Part D PDP plans in LA cover RAPAFLO CAPSULES 4MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RAPAFLO CAPSULES 8MG 90 BOT ![Compare how all Medicare Part D PDP plans in LA cover RAPAFLO CAPSULES 8MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in LA cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
Rasagiline Mesylate 0.5 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in LA cover Rasagiline Mesylate 0.5 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Rasagiline Mesylate 1 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in LA cover Rasagiline Mesylate 1 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RAVICTI 1.1 GRAM/ML LIQUID ![Compare how all Medicare Part D PDP plans in LA 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 |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REBETOL 40MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover REBETOL 40MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in LA cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RECOMBIVAX HB 10 MCG/ML SYR ![Compare how all Medicare Part D PDP plans in LA cover RECOMBIVAX HB 10 MCG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
RECOMBIVAX HB 5 MCG/0.5 ML SYR ![Compare how all Medicare Part D PDP plans in LA cover RECOMBIVAX HB 5 MCG/0.5 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in LA cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /15Days |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in LA cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:56 /180Days |
RELISTOR 12 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover RELISTOR 12 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
RELISTOR 12 MG/0.6 ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover RELISTOR 12 MG/0.6 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
RELISTOR 8 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in LA cover RELISTOR 8 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
RELPAX 20MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RELPAX 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | Q:18 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RELPAX 40MG TABLET 6X2 BLPK ![Compare how all Medicare Part D PDP plans in LA cover RELPAX 40MG TABLET 6X2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | Q:18 /30Days |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in LA 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 LA 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 LA 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 LA 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 LA cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RENAGEL 400MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RENAGEL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RENAGEL 800MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RENAGEL 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Repaglinide 0.5 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in LA cover Repaglinide 0.5 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Repaglinide 1 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in LA cover Repaglinide 1 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Repaglinide 2 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in LA cover Repaglinide 2 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
REPAGLINIDE-METFORMIN 1-500 MG [PrandiMet] ![Compare how all Medicare Part D PDP plans in LA cover REPAGLINIDE-METFORMIN 1-500 MG [PrandiMet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
REPAGLINIDE-METFORMIN 2-500 MG [PrandiMet] ![Compare how all Medicare Part D PDP plans in LA cover REPAGLINIDE-METFORMIN 2-500 MG [PrandiMet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RESCRIPTOR 100mg/1 360 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover RESCRIPTOR 100mg/1 360 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
RESCRIPTOR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RESCRIPTOR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in LA 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 |
$47.00 | $141.00 | None |
RETIN-A MICRO PUMP 0.08% GEL ![Compare how all Medicare Part D PDP plans in LA cover RETIN-A MICRO PUMP 0.08% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | P |
RETROVIR 200 MG/20 ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover RETROVIR 200 MG/20 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
REVLIMID 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in LA 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:30 /30Days |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in LA 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 |
REVLIMID 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA 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 |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVLIMID 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA 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 LA 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 LA cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
REXULTI 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover REXULTI 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
REXULTI 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover REXULTI 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
REXULTI 1 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover REXULTI 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
REXULTI 2 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover REXULTI 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
REXULTI 3 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover REXULTI 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
REXULTI 4 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover REXULTI 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover REYATAZ 200MG CAPSULE.](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 |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
REYATAZ 50 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in LA cover REYATAZ 50 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RIBASPHERE 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIBASPHERE 400MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RIBASPHERE 600MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RIBASPHERE RibaPak ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE RibaPak .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RIBASPHERE RibaPak 400mg/1 ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE RibaPak 400mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RIBASPHERE RibaPak 600mg/1 ![Compare how all Medicare Part D PDP plans in LA cover RIBASPHERE RibaPak 600mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
RIBAVIRIN 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RIBAVIRIN 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in LA cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIDAURA 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RIDAURA 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
RIFABUTIN 150 MG CAPSULE [Mycobutin] ![Compare how all Medicare Part D PDP plans in LA cover RIFABUTIN 150 MG CAPSULE [Mycobutin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIFAMATE 150/300 CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RIFAMATE 150/300 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in LA cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Rifampin IV 600 MG Vial ![Compare how all Medicare Part D PDP plans in LA cover Rifampin IV 600 MG Vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIFATER 50/300/120 TABLET ![Compare how all Medicare Part D PDP plans in LA cover RIFATER 50/300/120 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
riluzole 50 mg tablet [Rilutek] ![Compare how all Medicare Part D PDP plans in LA cover riluzole 50 mg tablet [Rilutek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Rimantadine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover Rimantadine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RINGERS 33/30/860 INJECTION ![Compare how all Medicare Part D PDP plans in LA cover RINGERS 33/30/860 INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in LA cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in LA cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RISEDRONATE SODIUM 150 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in LA cover RISEDRONATE SODIUM 150 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISEDRONATE SODIUM 30 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in LA cover RISEDRONATE SODIUM 30 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in LA cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in LA cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in LA cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISEDRONATE SODIUM 5 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in LA cover RISEDRONATE SODIUM 5 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in LA cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in LA cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in LA cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in LA cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RISPERIDONE 0.5 MG 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 0.5 MG 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RISPERIDONE 0.5 MG ODT ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 0.5 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISPERIDONE 1 MG 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in LA 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) |
2 |
Generic |
$10.00 | $30.00 | None |
RISPERIDONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RISPERIDONE 1 MG/ML 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 1 MG/ML 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISPERIDONE 2 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 2 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RISPERIDONE 2 MG ODT ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 2 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISPERIDONE 3 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 3 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RISPERIDONE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in LA cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RITALIN LA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RITALIN LA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | None |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA 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 LA cover RIVASTIGMINE 13.3 MG/24HR PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIVASTIGMINE 4.6 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in LA cover RIVASTIGMINE 4.6 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIVASTIGMINE 9.5 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in LA cover RIVASTIGMINE 9.5 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIVASTIGMINE TARTRATE 3MG CAPSULES ![Compare how all Medicare Part D PDP plans in LA cover RIVASTIGMINE TARTRATE 3MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIVASTIGMINE TARTRATE 4.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in LA cover RIVASTIGMINE TARTRATE 4.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIVASTIGMINE TARTRATE 6MG CAPSULES ![Compare how all Medicare Part D PDP plans in LA cover RIVASTIGMINE TARTRATE 6MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
RIVASTIGMINE TARTRATE1.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in LA cover RIVASTIGMINE TARTRATE1.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Rivelsa tablet ![Compare how all Medicare Part D PDP plans in LA cover Rivelsa tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Rizatriptan 10 mg odt ![Compare how all Medicare Part D PDP plans in LA cover Rizatriptan 10 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:36 /60Days |
Rizatriptan 10 mg tablet ![Compare how all Medicare Part D PDP plans in LA cover Rizatriptan 10 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:36 /60Days |
Rizatriptan 5 mg odt ![Compare how all Medicare Part D PDP plans in LA cover Rizatriptan 5 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:36 /60Days |
Rizatriptan 5 mg tablet ![Compare how all Medicare Part D PDP plans in LA cover Rizatriptan 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | Q:36 /60Days |
ROPINIROLE HCL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HCL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HYDROCLORIDE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE HYDROCLORIDE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROPINIROLE TAB 12MG ER ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE TAB 12MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ROPINIROLE TAB 2MG ER ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE TAB 2MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ROPINIROLE TAB 4MG ER ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE TAB 4MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ROPINIROLE TAB 6MG ER ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE TAB 6MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ROPINIROLE TAB 8MG ER ![Compare how all Medicare Part D PDP plans in LA cover ROPINIROLE TAB 8MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in LA cover ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in LA cover ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
Rosuvastatin calcium 40 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in LA cover Rosuvastatin calcium 40 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in LA cover ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $0.00 | None |
ROTARIX VACCINE SUSPENSION ![Compare how all Medicare Part D PDP plans in LA cover ROTARIX VACCINE SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in LA cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Roweepra 1,000 mg tablet ![Compare how all Medicare Part D PDP plans in LA cover Roweepra 1,000 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Roweepra 500 mg tablet ![Compare how all Medicare Part D PDP plans in LA cover Roweepra 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
Roweepra 750 mg tablet ![Compare how all Medicare Part D PDP plans in LA cover Roweepra 750 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $30.00 | None |
ROZEREM 8MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover ROZEREM 8MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | P Q:30 /30Days |
RUBRACA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RUBRACA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RUBRACA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover RUBRACA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RUCONEST 2,100 UNIT VIAL ![Compare how all Medicare Part D PDP plans in LA cover RUCONEST 2,100 UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RYDAPT 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover RYDAPT 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
RYTARY ER 23.75 MG-95 MG CAP ![Compare how all Medicare Part D PDP plans in LA cover RYTARY ER 23.75 MG-95 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | S |
RYTARY ER 36.25 MG-145 MG CAP ![Compare how all Medicare Part D PDP plans in LA cover RYTARY ER 36.25 MG-145 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RYTARY ER 48.75 MG-195 MG CAP ![Compare how all Medicare Part D PDP plans in LA cover RYTARY ER 48.75 MG-195 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | S |
RYTARY ER 61.25 MG-245 MG CAP ![Compare how all Medicare Part D PDP plans in LA cover RYTARY ER 61.25 MG-245 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$100.00 | $300.00 | S |