2017 Medicare Part D Plan Formulary Information |
Vital Plus (HMO SNP) (H5774-022-0)
Benefit Details
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The Vital Plus (HMO SNP) (H5774-022-0) Formulary Drugs Starting with the Letter C in Guayanilla County, PR: CMS MA Region 30 which includes: PR Plan Monthly Premium: $28.00 Deductible: $0 |
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CABERGOLINE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CABERGOLINE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CABOMETYX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CABOMETYX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CABOMETYX 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CABOMETYX 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CABOMETYX 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CABOMETYX 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CALCIPOTRIENE 0.005% CREAM ![Compare how all Medicare Part D PDP plans in PR cover CALCIPOTRIENE 0.005% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Calcipotriene 50ug/g 60 g per CARTON ![Compare how all Medicare Part D PDP plans in PR cover Calcipotriene 50ug/g 60 g per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CALCIPOTRIENE TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CALCIPOTRIENE TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in PR cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:4 /30Days |
CALCITRIOL 0.25MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CALCITRIOL 0.25MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CALCITRIOL 0.5 MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CALCITRIOL 0.5 MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Calcitriol 1 mcg/ml ampul ![Compare how all Medicare Part D PDP plans in PR cover Calcitriol 1 mcg/ml ampul.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CALCITRIOL 1MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in PR cover CALCITRIOL 1MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in PR cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CANASA 1,000 MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in PR cover CANASA 1,000 MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
CANCIDAS IV 50MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover CANCIDAS IV 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CANCIDAS IV 70MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover CANCIDAS IV 70MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CANDESARTAN CILEXETIL 16 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PR cover CANDESARTAN CILEXETIL 16 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CANDESARTAN CILEXETIL 32 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PR cover CANDESARTAN CILEXETIL 32 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CANDESARTAN CILEXETIL 4 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PR cover CANDESARTAN CILEXETIL 4 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CANDESARTAN CILEXETIL 8 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PR cover CANDESARTAN CILEXETIL 8 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
candesartan-hctz 16-12.5 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover candesartan-hctz 16-12.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
candesartan-hctz 32-12.5 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover candesartan-hctz 32-12.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
candesartan-hctz 32-25 mg ![Compare how all Medicare Part D PDP plans in PR cover candesartan-hctz 32-25 mg.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CAPASTAT SULFATE 1g/1 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in PR cover CAPASTAT SULFATE 1g/1 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CAPRELSA 100mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover CAPRELSA 100mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CAPRELSA 300mg/1 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover CAPRELSA 300mg/1 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CARAFATE SUS 1GM/10ML ![Compare how all Medicare Part D PDP plans in PR cover CARAFATE SUS 1GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Carbaglu 200mg/1 5 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Carbaglu 200mg/1 5 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CARBAMAZEPINE 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover CARBAMAZEPINE 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Carbamazepine 100mg, CHEWABLE 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Carbamazepine 100mg, CHEWABLE 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CARBAMAZEPINE ER 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CARBAMAZEPINE ER 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARBAMAZEPINE TABLET USP 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PR cover CARBAMAZEPINE TABLET USP 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBAMAZEPINE XR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CARBAMAZEPINE XR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARBAMAZEPINE XR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CARBAMAZEPINE XR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CARBIDOPA 25 MG TABLET [Lodosyn] ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA 25 MG TABLET [Lodosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Carbidopa and Levodopa 25; 100mg/1; mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, EXTENDED ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa and Levodopa 25; 100mg/1; mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, EXTENDED .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Carbidopa and Levodopa 50; 200mg/1; mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, EXTENDED ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa and Levodopa 50; 200mg/1; mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, EXTENDED .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;250MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA AND LEVODOPA ORALLY DISINTEGRATING TABLETS 25;250MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARBIDOPA-LEVODOPA 10-100 TAB ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA-LEVODOPA 10-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CARBIDOPA-LEVODOPA 25-100 TAB ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA-LEVODOPA 25-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CARBIDOPA-LEVODOPA 25-250 TAB ![Compare how all Medicare Part D PDP plans in PR cover CARBIDOPA-LEVODOPA 25-250 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Carbidopa-Levodopa-Entacapone 100 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa-Levodopa-Entacapone 100 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Carbidopa-Levodopa-Entacapone 125 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa-Levodopa-Entacapone 125 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Carbidopa-Levodopa-Entacapone 150 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa-Levodopa-Entacapone 150 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Carbidopa-Levodopa-Entacapone 200 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa-Levodopa-Entacapone 200 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Carbidopa-Levodopa-Entacapone 50 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa-Levodopa-Entacapone 50 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Carbidopa-Levodopa-Entacapone 75 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PR cover Carbidopa-Levodopa-Entacapone 75 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Carboplatin 10mg/mL ![Compare how all Medicare Part D PDP plans in PR cover Carboplatin 10mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CARIMUNE NF 6GM VIAL ![Compare how all Medicare Part D PDP plans in PR cover CARIMUNE NF 6GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PR cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PR cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PR cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARTIA XT 300MG CAPSULE SR 24 HR ![Compare how all Medicare Part D PDP plans in PR cover CARTIA XT 300MG CAPSULE SR 24 HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Carvedilol 12.5mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Carvedilol 12.5mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Carvedilol 25mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Carvedilol 25mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Carvedilol 3.125mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Carvedilol 3.125mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Carvedilol 6.25mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Carvedilol 6.25mg 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CAYSTON KIT 75 MG/VIAL ![Compare how all Medicare Part D PDP plans in PR cover CAYSTON KIT 75 MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CEFACLOR 250 MG CAPSULES ![Compare how all Medicare Part D PDP plans in PR cover CEFACLOR 250 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFACLOR 500 MG CAPSULES ![Compare how all Medicare Part D PDP plans in PR cover CEFACLOR 500 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFADROXIL 1G TABLET ![Compare how all Medicare Part D PDP plans in PR cover CEFADROXIL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFADROXIL 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover CEFADROXIL 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFADROXIL 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CEFADROXIL 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cefadroxil 500mg/5mL ![Compare how all Medicare Part D PDP plans in PR cover Cefadroxil 500mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Cefazolin 1 gm vial ![Compare how all Medicare Part D PDP plans in PR cover Cefazolin 1 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE ![Compare how all Medicare Part D PDP plans in PR cover Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFAZOLIN 500MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover CEFAZOLIN 500MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in PR cover CEFDINIR 250MG/5ML SUSPENSION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFDINIR CAPSULES 300MG (60 CT) ![Compare how all Medicare Part D PDP plans in PR cover CEFDINIR CAPSULES 300MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover CEFDINIR FOR ORAL SUSPENSION 125MG/5ML (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFEPIME INJ 1GM 20ML APX 10x1G VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEFEPIME INJ 1GM 20ML APX 10x1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cefotaxime sodium 1 gm vial ![Compare how all Medicare Part D PDP plans in PR cover Cefotaxime sodium 1 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cefotaxime sodium 2 gm vial ![Compare how all Medicare Part D PDP plans in PR cover Cefotaxime sodium 2 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cefotaxime sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in PR cover Cefotaxime sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cefoxitin 1g/1 10 POWDER per CARTON ![Compare how all Medicare Part D PDP plans in PR cover Cefoxitin 1g/1 10 POWDER per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cefoxitin 2g/1 10 POWDER per CARTON ![Compare how all Medicare Part D PDP plans in PR cover Cefoxitin 2g/1 10 POWDER per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFOXITIN FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CEFOXITIN FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFTAZIDIME 1g 25 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEFTAZIDIME 1g 25 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN ![Compare how all Medicare Part D PDP plans in PR cover CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN ![Compare how all Medicare Part D PDP plans in PR cover CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFTRIAXONE 10GM VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEFTRIAXONE 10GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFTRIAXONE 250 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEFTRIAXONE 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFTRIAXONE FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover CEFTRIAXONE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFTRIAXONE FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover CEFTRIAXONE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ceftriaxone Sodium 500mg ![Compare how all Medicare Part D PDP plans in PR cover Ceftriaxone Sodium 500mg.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFUROXIME 1.5 GM/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover CEFUROXIME 1.5 GM/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFUROXIME 7.5 GM FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover CEFUROXIME 7.5 GM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CEFUROXIME 750 MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover CEFUROXIME 750 MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cefuroxime Axetil 250 MG ![Compare how all Medicare Part D PDP plans in PR cover Cefuroxime Axetil 250 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEFUROXIME AXETIL 500 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover CEFUROXIME AXETIL 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CELECOXIB 100 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PR cover CELECOXIB 100 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | S |
CELECOXIB 200 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PR cover CELECOXIB 200 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | S |
CELECOXIB 400 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PR cover CELECOXIB 400 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | S |
CELECOXIB 50 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PR cover CELECOXIB 50 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | S |
CELONTIN 300 MG KAPSEAL ![Compare how all Medicare Part D PDP plans in PR cover CELONTIN 300 MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cephalexin 125mg/5mL 200 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Cephalexin 125mg/5mL 200 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CEPHALEXIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CEPHALEXIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CEPHALEXIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CEPHALEXIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CEPHALEXIN 250 MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in PR cover CEPHALEXIN 250 MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CEPHALEXIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CEPHALEXIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CEPHALEXIN CAPSULES 500 MG (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover CEPHALEXIN CAPSULES 500 MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CEREBYX 500 MG PE/10 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEREBYX 500 MG PE/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CEREZYME 400 UNITS VIAL ![Compare how all Medicare Part D PDP plans in PR cover CEREZYME 400 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CETIRIZINE HCL 1 MG/ML SOLN ![Compare how all Medicare Part D PDP plans in PR cover CETIRIZINE HCL 1 MG/ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CEVIMELINE HCL 30 MG CAPSULE [Evoxac] ![Compare how all Medicare Part D PDP plans in PR cover CEVIMELINE HCL 30 MG CAPSULE [Evoxac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CHANTIX 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHANTIX 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P Q:336 /365Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHANTIX 1 MG CONT MONTH BOX ![Compare how all Medicare Part D PDP plans in PR cover CHANTIX 1 MG CONT MONTH BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P Q:336 /365Days |
CHANTIX 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHANTIX 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P Q:336 /365Days |
CHANTIX STARTING MONTH BOX ![Compare how all Medicare Part D PDP plans in PR cover CHANTIX STARTING MONTH BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P Q:53 /28Days |
CHEMET 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CHEMET 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CHLORAMPHEN NA SUCC 1GM VL ![Compare how all Medicare Part D PDP plans in PR cover CHLORAMPHEN NA SUCC 1GM VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CHLORHEXIDINE GLUCONATE 0.12% RINSE ![Compare how all Medicare Part D PDP plans in PR cover CHLORHEXIDINE GLUCONATE 0.12% RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CHLOROQUINE PH 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLOROQUINE PH 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CHLOROQUINE PH 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLOROQUINE PH 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CHLOROTHIAZIDE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLOROTHIAZIDE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Chlorothiazide 500mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Chlorothiazide 500mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CHLORPROMAZINE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLORPROMAZINE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORPROMAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLORPROMAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CHLORPROMAZINE 25 MG/ML AMP ![Compare how all Medicare Part D PDP plans in PR cover CHLORPROMAZINE 25 MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CHLORPROMAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLORPROMAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CHLORPROMAZINE HCL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CHLORPROMAZINE HCL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Chlorpromazine Hydrochloride 100mg SUGAR COATED 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Chlorpromazine Hydrochloride 100mg SUGAR COATED 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CHLORTHALIDONE 25 MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover CHLORTHALIDONE 25 MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CHLORTHALIDONE 50 MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PR cover CHLORTHALIDONE 50 MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CHOLESTYRAMINE LIGHT POWDER ![Compare how all Medicare Part D PDP plans in PR cover CHOLESTYRAMINE LIGHT POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover CHOLESTYRAMINE LIGHT POWDER FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in PR cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cilostazol 50mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Cilostazol 50mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CILOSTAZOL TABLET 100MG (60 CT) ![Compare how all Medicare Part D PDP plans in PR cover CILOSTAZOL TABLET 100MG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Cimetidine 200mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Cimetidine 200mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CIMETIDINE 300 MG TABLETS ![Compare how all Medicare Part D PDP plans in PR cover CIMETIDINE 300 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Cimetidine 400mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Cimetidine 400mg/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 |
Cimetidine 800mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Cimetidine 800mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Cinryze 500[iU]/5mL 1 VIAL per CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover Cinryze 500[iU]/5mL 1 VIAL per CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CIPRODEX OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover CIPRODEX OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CIPROFLOXACIN 0.3% EYE DROP ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN 0.3% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CIPROFLOXACIN 250 MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN 250 MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CIPROFLOXACIN 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Ciprofloxacin 400 mg/40 ml vl ![Compare how all Medicare Part D PDP plans in PR cover Ciprofloxacin 400 mg/40 ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPROFLOXACIN 500 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN 500 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Ciprofloxacin and Dextrose 2mg/mL 24 BAG in 1 CASE / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in PR cover Ciprofloxacin and Dextrose 2mg/mL 24 BAG in 1 CASE / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CIPROFLOXACIN HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CIPROFLOXACIN HCL 500 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN HCL 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CIPROFLOXACIN TABLETS 750 MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CIPROFLOXACIN TABLETS 750 MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Cisplatin 100mg/100mL 1 VIAL per CARTON / 100 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover Cisplatin 100mg/100mL 1 VIAL per CARTON / 100 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CITALOPRAM HBR 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CITALOPRAM HBR 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CITALOPRAM HBR 10 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in PR cover CITALOPRAM HBR 10 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CITALOPRAM HBR 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CITALOPRAM HBR 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CITALOPRAM HYDROBROMIDE TABLETS 40 MG 30 BOT ![Compare how all Medicare Part D PDP plans in PR cover CITALOPRAM HYDROBROMIDE TABLETS 40 MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
Cladribine 10 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in PR cover Cladribine 10 mg/10 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 |
CLARAVIS 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLARAVIS 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CLARAVIS 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLARAVIS 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Claravis 30mg 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Claravis 30mg 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CLARAVIS 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLARAVIS 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLARITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLARITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLARITHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLARITHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLARITHROMYCIN ER 500 MG TAB ![Compare how all Medicare Part D PDP plans in PR cover CLARITHROMYCIN ER 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Clindamycin 150 MG/ML 2ml ![Compare how all Medicare Part D PDP plans in PR cover Clindamycin 150 MG/ML 2ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | P |
Clindamycin 150 MG/ML 6ml ![Compare how all Medicare Part D PDP plans in PR cover Clindamycin 150 MG/ML 6ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN 600 MG/4 ML ADDVAN ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN 600 MG/4 ML ADDVAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CLINDAMYCIN HCL 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN HCL 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN HCL 300 MG 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN HCL 300 MG 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN HCL 75 MG 200 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN HCL 75 MG 200 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN PEDIATR 75 MG/5 ML ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN PEDIATR 75 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
clindamycin phosphate 10mg/mL 1 BOTTLE per CARTON / 60 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover clindamycin phosphate 10mg/mL 1 BOTTLE per CARTON / 60 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLINDAMYCIN PHOSPHATE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in PR cover CLINDAMYCIN PHOSPHATE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
clindamycin-d5w 300 mg/50 ml ![Compare how all Medicare Part D PDP plans in PR cover clindamycin-d5w 300 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
clindamycin-d5w 600 mg/50 ml ![Compare how all Medicare Part D PDP plans in PR cover clindamycin-d5w 600 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
clindamycin-d5w 900 mg/50 ml ![Compare how all Medicare Part D PDP plans in PR cover clindamycin-d5w 900 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CLINIMIX 2.75%/5% INJECTION 1000ML BAG ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 2.75%/5% INJECTION 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 4.25/10 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 4.25/10 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 4.25/20 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 4.25/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 4.25/25 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 4.25/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 4.25/5 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 4.25/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 5/15 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 5/15 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 5/20 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 5/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX 5/25 SULFITE FREE INJECTIONS 1035MG-420MEQ 1000ML BAG ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX 5/25 SULFITE FREE INJECTIONS 1035MG-420MEQ 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX E 2.75/10 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 2.75/10 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINIMIX E 2.75/5 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 2.75/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX E 4.25/25 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 4.25/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX E 4.25/5 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 4.25/5 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX E 5/20 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 5/20 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX E 5/25 SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 5/25 SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINIMIX E 5%/15% INJECTION 2000ML BAG ![Compare how all Medicare Part D PDP plans in PR cover CLINIMIX E 5%/15% INJECTION 2000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLINISOL 15% SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLINISOL 15% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in PR cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CLOBETASOL 0.05% SHAMPOO ![Compare how all Medicare Part D PDP plans in PR cover CLOBETASOL 0.05% SHAMPOO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CLOBETASOL E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in PR cover CLOBETASOL E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Clobetasol Propionate 0.4625mg/mL 1 BOTTLE per CARTON / 50 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Clobetasol Propionate 0.4625mg/mL 1 BOTTLE per CARTON / 50 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Clofarabine 20 mg/20 ml vial [Clolar] ![Compare how all Medicare Part D PDP plans in PR cover Clofarabine 20 mg/20 ml vial [Clolar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CLOMIPRAMINE HCL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLOMIPRAMINE HCL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLOMIPRAMINE HCL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLOMIPRAMINE HCL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CLOMIPRAMINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CLOMIPRAMINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
Clonazepam 0.125mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 0.125mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PAC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:120 /30Days |
Clonazepam 0.25mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 0.25mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:120 /30Days |
Clonazepam 0.5mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 0.5mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:120 /30Days |
Clonazepam 0.5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 0.5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:120 /30Days |
CLONAZEPAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLONAZEPAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:120 /30Days |
Clonazepam 1mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 1mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:120 /30Days |
Clonazepam 2mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 2mg/1 10 BLISTER PACK per CARTON / 6 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | Q:300 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Clonazepam 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Clonazepam 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | Q:300 /30Days |
Clonidine 0.1mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in PR cover Clonidine 0.1mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Clonidine 0.2mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in PR cover Clonidine 0.2mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Clonidine 0.3mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in PR cover Clonidine 0.3mg/d 4 POUCH per CARTON / 1 PATCH in 1 POUCH / 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CLONIDINE HCL 0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLONIDINE HCL 0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CLONIDINE HCL 0.2MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover CLONIDINE HCL 0.2MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CLONIDINE HCL ER 0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLONIDINE HCL ER 0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLONIDINE HCL TABLET 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover CLONIDINE HCL TABLET 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CLOPIDOGREL 75 MG TABLET [Plavix] ![Compare how all Medicare Part D PDP plans in PR cover CLOPIDOGREL 75 MG TABLET [Plavix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | None |
CLORAZEPATE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLORAZEPATE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | Q:180 /30Days |
Clorazepate Dipotassium 3.75mg/1 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Clorazepate Dipotassium 3.75mg/1 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Clorazepate Dipotassium 7.5mg/1 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Clorazepate Dipotassium 7.5mg/1 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | N/A | Q:180 /30Days |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in PR cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOTRIMAZOLE 1% SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover CLOTRIMAZOLE 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOTRIMAZOLE 10MG TROCHE ![Compare how all Medicare Part D PDP plans in PR cover CLOTRIMAZOLE 10MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION ![Compare how all Medicare Part D PDP plans in PR cover CLOTRIMAZOLE-BETAMETHASONE 1-0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PR cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Clozapine 100 MG Disintegrating Oral Tablet ![Compare how all Medicare Part D PDP plans in PR cover Clozapine 100 MG Disintegrating Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
Clozapine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Clozapine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOZAPINE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover CLOZAPINE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Clozapine 25 MG Disintegrating Oral Tablet ![Compare how all Medicare Part D PDP plans in PR cover Clozapine 25 MG Disintegrating Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOZAPINE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover CLOZAPINE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOZAPINE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PR cover CLOZAPINE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOZAPINE ODT 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLOZAPINE ODT 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CLOZAPINE ODT 150 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLOZAPINE ODT 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | S |
CLOZAPINE ODT 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover CLOZAPINE ODT 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | S |
COARTEM 20MG-120MG ![Compare how all Medicare Part D PDP plans in PR cover COARTEM 20MG-120MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
COLCHICINE 0.6 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover COLCHICINE 0.6 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COLCHICINE 0.6 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COLCHICINE 0.6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COLCRYS 0.6 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COLCRYS 0.6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
COLESTIPOL HCL 1G TABLET ![Compare how all Medicare Part D PDP plans in PR cover COLESTIPOL HCL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
COLESTIPOL HYDROCHLORIDE 5g/1 100 SUSPENSION in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover COLESTIPOL HYDROCHLORIDE 5g/1 100 SUSPENSION in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
colistimethate 150mg/2mL 1 VIAL per CARTON / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover colistimethate 150mg/2mL 1 VIAL per CARTON / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COLOCORT 100MG ENEMA ![Compare how all Medicare Part D PDP plans in PR cover COLOCORT 100MG ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
COMBIGAN 0.2%-0.5% DROPS ![Compare how all Medicare Part D PDP plans in PR cover COMBIGAN 0.2%-0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | Q:5 /25Days |
COMBIVENT RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in PR cover COMBIVENT RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | Q:8 /30Days |
COMETRIQ 100 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in PR cover COMETRIQ 100 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COMETRIQ 140 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in PR cover COMETRIQ 140 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COMETRIQ 60 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in PR cover COMETRIQ 60 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in PR cover COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
CONSTULOSE 10 GM/15 ML SOLN ![Compare how all Medicare Part D PDP plans in PR cover CONSTULOSE 10 GM/15 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in PR cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COPAXONE 40 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover COPAXONE 40 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Cortisone 25 MG Tablet ![Compare how all Medicare Part D PDP plans in PR cover Cortisone 25 MG Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COSENTYX 150 MG/ML PEN INJECT ![Compare how all Medicare Part D PDP plans in PR cover COSENTYX 150 MG/ML PEN INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COSMEGEN 0.5 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover COSMEGEN 0.5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COTELLIC 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COTELLIC 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
COUMADIN 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 3mg/1 1 BOTTLE per CARTON / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 3mg/1 1 BOTTLE per CARTON / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 4mg/1 1 BOTTLE in 1 CARTON / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 4mg/1 1 BOTTLE in 1 CARTON / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
COUMADIN 6MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COUMADIN 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover COUMADIN 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT ![Compare how all Medicare Part D PDP plans in PR cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CREON DR 36,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CREON DR 36,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
CRESEMBA 186 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CRESEMBA 186 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CRESEMBA 372 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover CRESEMBA 372 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | None |
CRIXIVAN 400mg, 180 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover CRIXIVAN 400mg, 180 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | None |
CROMOLYN 20 MG/2 ML NEB SOLN ![Compare how all Medicare Part D PDP plans in PR cover CROMOLYN 20 MG/2 ML NEB SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P Q:240 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CROMOLYN SODIUM 100 MG/5 ML ![Compare how all Medicare Part D PDP plans in PR cover CROMOLYN SODIUM 100 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in PR cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | None |
Cyclobenzaprine 7.5 mg tablet ![Compare how all Medicare Part D PDP plans in PR cover Cyclobenzaprine 7.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PR cover CYCLOBENZAPRINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cyclobenzaprine Hydrochloride 5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PR cover Cyclobenzaprine Hydrochloride 5mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYCLOPHOSPHAMIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CYCLOPHOSPHAMIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | P |
CYCLOPHOSPHAMIDE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CYCLOPHOSPHAMIDE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35.00 | N/A | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
Cyclosporine 50 mg/ml vial ![Compare how all Medicare Part D PDP plans in PR cover Cyclosporine 50 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYCLOSPORINE MODIFIED 100 MG ![Compare how all Medicare Part D PDP plans in PR cover CYCLOSPORINE MODIFIED 100 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOSPORINE MODIFIED 25 MG ![Compare how all Medicare Part D PDP plans in PR cover CYCLOSPORINE MODIFIED 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYCLOSPORINE MODIFIED 50 MG ![Compare how all Medicare Part D PDP plans in PR cover CYCLOSPORINE MODIFIED 50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in PR cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYPROHEPTADINE HCL 4 MG ![Compare how all Medicare Part D PDP plans in PR cover CYPROHEPTADINE HCL 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL ![Compare how all Medicare Part D PDP plans in PR cover CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |
CYRAMZA 100 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover CYRAMZA 100 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CYRAMZA 500 MG/50 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover CYRAMZA 500 MG/50 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
CYSTADANE 1 GRAM/1.7 ML POWDER ![Compare how all Medicare Part D PDP plans in PR cover CYSTADANE 1 GRAM/1.7 ML POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$50.00 | N/A | P |
CYSTARAN 0.44% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover CYSTARAN 0.44% EYE DROPS.](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 |
CYTARABINE 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover CYTARABINE 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | N/A | P |