2018 Medicare Part D Plan Formulary Information |
SelectHealth Advantage Essential (HMO) (H1994-003-0)
Benefit Details
![Email Prescription and/or Health Benefit details for SelectHealth Advantage Essential (HMO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The SelectHealth Advantage Essential (HMO) (H1994-003-0) Formulary Drugs Starting with the Letter V in Boise County, ID: CMS MA Region 23 which includes: ID Plan Monthly Premium: $14.00 Deductible: $150 |
Drugs Starting with Letter V
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
VALACYCLOVIR HCL 1 GRAM TABLET ![Compare how all Medicare Part D PDP plans in ID cover VALACYCLOVIR HCL 1 GRAM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:30 /30Days |
VALACYCLOVIR HCL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VALACYCLOVIR HCL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:60 /30Days |
VALCHLOR 0.016% GEL ![Compare how all Medicare Part D PDP plans in ID cover VALCHLOR 0.016% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:120 /30Days |
VALGANCICLOVIR 450 MG TABLET [Valcyte] ![Compare how all Medicare Part D PDP plans in ID cover VALGANCICLOVIR 450 MG TABLET [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:90 /30Days |
VALGANCICLOVIR HCL 50 MG/ML [Valcyte] ![Compare how all Medicare Part D PDP plans in ID cover VALGANCICLOVIR HCL 50 MG/ML [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VALPROATE SOD 500 MG/5 ML VIAL [Depacon] ![Compare how all Medicare Part D PDP plans in ID cover VALPROATE SOD 500 MG/5 ML VIAL [Depacon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
VALPROIC ACID 250 MG CAPSULE [Depakene] ![Compare how all Medicare Part D PDP plans in ID cover VALPROIC ACID 250 MG CAPSULE [Depakene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:540 /30Days |
VALPROIC ACID 500 MG/10 ML Solution [Depakene] ![Compare how all Medicare Part D PDP plans in ID cover VALPROIC ACID 500 MG/10 ML Solution [Depakene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:3000 /30Days |
VALSARTAN 160 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN 160 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN 320 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN 320 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VALSARTAN 40 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN 40 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN 80 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN 80 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN-HCTZ 160-25 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN-HCTZ 160-25 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN-HCTZ 320-12.5 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN-HCTZ 320-12.5 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN-HCTZ 320-25 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN-HCTZ 320-25 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VALSARTAN-HCTZ 80-12.5 MG Tablet [Diovan HCT] ![Compare how all Medicare Part D PDP plans in ID cover VALSARTAN-HCTZ 80-12.5 MG Tablet [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | Q:60 /30Days |
VANCOMYCIN 500 MG VIAL ![Compare how all Medicare Part D PDP plans in ID cover VANCOMYCIN 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
VANCOMYCIN HCL 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VANCOMYCIN HCL 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:120 /30Days |
VANCOMYCIN HCL 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VANCOMYCIN HCL 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:120 /30Days |
VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE ) ![Compare how all Medicare Part D PDP plans in ID cover VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE ).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA ![Compare how all Medicare Part D PDP plans in ID cover VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
VANDAZOLE 0.75% GEL WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in ID cover VANDAZOLE 0.75% GEL WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VAQTA 25 UNITS/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in ID cover VAQTA 25 UNITS/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
VAQTA 50 UNITS/ML SYRINGE ![Compare how all Medicare Part D PDP plans in ID cover VAQTA 50 UNITS/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
Vaqta Hepatitis A Vaccine Adult 50 Unit / mL Injection Single Dose Vial 1 mL ![Compare how all Medicare Part D PDP plans in ID cover Vaqta Hepatitis A Vaccine Adult 50 Unit / mL Injection Single Dose Vial 1 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL ![Compare how all Medicare Part D PDP plans in ID cover Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
VARIVAX VACCINE W/DILUENT ![Compare how all Medicare Part D PDP plans in ID cover VARIVAX VACCINE W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
VARUBI 90 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VARUBI 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | P Q:2 /14Days |
VASCEPA 0.5 GM CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VASCEPA 0.5 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | Q:120 /30Days |
VASCEPA 1 GM CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VASCEPA 1 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | Q:120 /30Days |
VECTIBIX 100 MG/5 ML VIAL ![Compare how all Medicare Part D PDP plans in ID cover VECTIBIX 100 MG/5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VELCADE 3.5MG VIAL ![Compare how all Medicare Part D PDP plans in ID cover VELCADE 3.5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
VELIVET 28 DAY TABLET [Velivet] ![Compare how all Medicare Part D PDP plans in ID cover VELIVET 28 DAY TABLET [Velivet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VELPHORO 500 MG CHEWABLE TAB ![Compare how all Medicare Part D PDP plans in ID cover VELPHORO 500 MG CHEWABLE TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:180 /30Days |
VELTASSA 16.8 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in ID cover VELTASSA 16.8 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
VELTASSA 25.2 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in ID cover VELTASSA 25.2 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
VELTASSA 8.4 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in ID cover VELTASSA 8.4 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
VENCLEXTA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VENCLEXTA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | P Q:120 /30Days |
VENCLEXTA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VENCLEXTA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:120 /30Days |
VENCLEXTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VENCLEXTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | P Q:120 /30Days |
VENCLEXTA STARTING PACK ![Compare how all Medicare Part D PDP plans in ID cover VENCLEXTA STARTING PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:120 /30Days |
VENLAFAXINE HCL 100 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL 100 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VENLAFAXINE HCL 25 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL 25 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VENLAFAXINE HCL 37.5 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL 37.5 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VENLAFAXINE HCL 50 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL 50 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VENLAFAXINE HCL 75 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL 75 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VENLAFAXINE HCL ER 150 MG CAPSULE 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL ER 150 MG CAPSULE 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:60 /30Days |
VENLAFAXINE HCL ER 37.5 MG CAPSULE 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL ER 37.5 MG CAPSULE 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:30 /30Days |
VENLAFAXINE HCL ER 75 MG CAPSULE 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in ID cover VENLAFAXINE HCL ER 75 MG CAPSULE 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | Q:90 /30Days |
Ventavis 0.01mg/mL ![Compare how all Medicare Part D PDP plans in ID cover Ventavis 0.01mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
Ventavis 0.02mg/mL ![Compare how all Medicare Part D PDP plans in ID cover Ventavis 0.02mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
VENTOLIN HFA 90MCG INHALER ![Compare how all Medicare Part D PDP plans in ID cover VENTOLIN HFA 90MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:36 /30Days |
VERAPAMIL 120 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VERAPAMIL 120MG CAP PELLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL 120MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL 180MG CAP PELLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL 180MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL 240MG CAP PELLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL 240MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | None |
VERAPAMIL 80 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$3.00 | N/A | None |
VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL ER 120 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL ER 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL ER 180 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL ER 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT) ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL ER 240 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL ER 240 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERAPAMIL ER 300MG CAPSULE 24HR SR PELLETS ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL ER 300MG CAPSULE 24HR SR PELLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE ![Compare how all Medicare Part D PDP plans in ID cover VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VERIPRED 20 20 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in ID cover VERIPRED 20 20 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | None |
VERSACLOZ 50 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in ID cover VERSACLOZ 50 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:600 /30Days |
VERZENIO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERZENIO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
VERZENIO 150 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERZENIO 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
VERZENIO 200 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERZENIO 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
VERZENIO 50 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VERZENIO 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
VESICARE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VESICARE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VESICARE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VESICARE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VICTOZA 3-PAK 18 MG/3 ML PEN ![Compare how all Medicare Part D PDP plans in ID cover VICTOZA 3-PAK 18 MG/3 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | S Q:9 /30Days |
VIDEX 4 GM PEDIATRIC SOLN ![Compare how all Medicare Part D PDP plans in ID cover VIDEX 4 GM PEDIATRIC SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIDEX EC 125MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in ID cover VIDEX EC 125MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:30 /30Days |
VIENVA-28 TABLET ![Compare how all Medicare Part D PDP plans in ID cover VIENVA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | None |
VIGABATRIN 500 MG ORAL TABLET [SABRIL] ![Compare how all Medicare Part D PDP plans in ID cover VIGABATRIN 500 MG ORAL TABLET [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | P Q:180 /30Days |
VIGABATRIN 500 MG POWDER PACKET [SABRIL] ![Compare how all Medicare Part D PDP plans in ID cover VIGABATRIN 500 MG POWDER PACKET [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P Q:9000 /30Days |
VIIBRYD 10-20 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in ID cover VIIBRYD 10-20 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in ID cover VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in ID cover VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in ID cover VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VIMPAT 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in ID cover VIMPAT 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:1200 /30Days |
Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ID cover Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:60 /30Days |
Vimpat 10mg/mL 10 VIAL, GLASS per CARTON / 20 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in ID cover Vimpat 10mg/mL 10 VIAL, GLASS per CARTON / 20 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ID cover Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:60 /30Days |
Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ID cover Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:60 /30Days |
Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in ID cover Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:60 /30Days |
VINBLASTINE 1 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in ID cover VINBLASTINE 1 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
VINCRISTINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in ID cover VINCRISTINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | P |
VINCRISTINE 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in ID cover VINCRISTINE 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
VINORELBINE 50 MG/5 ML VIAL ![Compare how all Medicare Part D PDP plans in ID cover VINORELBINE 50 MG/5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
VIOKACE 10,440-39,150 UNITS TB ![Compare how all Medicare Part D PDP plans in ID cover VIOKACE 10,440-39,150 UNITS TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | None |
VIOKACE 20,880-78,300 UNITS TB ![Compare how all Medicare Part D PDP plans in ID cover VIOKACE 20,880-78,300 UNITS TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | None |
VIRACEPT 250MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VIRACEPT 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
VIRACEPT 625MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VIRACEPT 625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIRAMUNE 50MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in ID cover VIRAMUNE 50MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | Q:1200 /30Days |
VIREAD 150 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VIREAD 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:30 /30Days |
VIREAD 200 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VIREAD 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:30 /30Days |
VIREAD 250 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VIREAD 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | Q:30 /30Days |
VIREAD POWDER ![Compare how all Medicare Part D PDP plans in ID cover VIREAD POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | N/A | None |
VORICONAZOLE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VORICONAZOLE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P Q:90 /30Days |
VORICONAZOLE 200 MG VIAL ![Compare how all Medicare Part D PDP plans in ID cover VORICONAZOLE 200 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P |
Voriconazole 40 MG/ML Oral Suspension ![Compare how all Medicare Part D PDP plans in ID cover Voriconazole 40 MG/ML Oral Suspension.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P Q:450 /30Days |
VORICONAZOLE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VORICONAZOLE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | N/A | P Q:360 /30Days |
VOSEVI 400-100-100 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VOSEVI 400-100-100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:28 /28Days |
VOTRIENT 200 MG TABLET ![Compare how all Medicare Part D PDP plans in ID cover VOTRIENT 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VPRIV INJECTION SOLUTION 2.5 MG/ML ![Compare how all Medicare Part D PDP plans in ID cover VPRIV INJECTION SOLUTION 2.5 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
VRAYLAR 1.5 MG CAP ![Compare how all Medicare Part D PDP plans in ID cover VRAYLAR 1.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | S Q:30 /30Days |
VRAYLAR 1.5 MG-3 MG PACK ![Compare how all Medicare Part D PDP plans in ID cover VRAYLAR 1.5 MG-3 MG PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VRAYLAR 3 MG CAP ![Compare how all Medicare Part D PDP plans in ID cover VRAYLAR 3 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | S Q:30 /30Days |
VRAYLAR 4.5 MG CAP ![Compare how all Medicare Part D PDP plans in ID cover VRAYLAR 4.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | S Q:30 /30Days |
VRAYLAR 6 MG CAP ![Compare how all Medicare Part D PDP plans in ID cover VRAYLAR 6 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | S Q:30 /30Days |
VYVANSE 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VYVANSE 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VYVANSE 40MG CAPSULE 100 EA ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE 40MG CAPSULE 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VYVANSE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VYVANSE 70MG CAPSULE ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE 70MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VYVANSE CAPSULES 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE CAPSULES 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VYVANSE CAPSULES 60MG 100 BOT ![Compare how all Medicare Part D PDP plans in ID cover VYVANSE CAPSULES 60MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S Q:30 /30Days |
VYXEOS 44 MG-100 MG VIAL ![Compare how all Medicare Part D PDP plans in ID cover VYXEOS 44 MG-100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:2 /28Days |
VYZULTA 0.024% OPHTH SOLUTION ![Compare how all Medicare Part D PDP plans in ID cover VYZULTA 0.024% OPHTH SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | N/A | S |