2018 Medicare Part D Plan Formulary Information |
UnitedHealthcare Dual Complete (HMO SNP) (H3113-009-0)
Benefit Details
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The UnitedHealthcare Dual Complete (HMO SNP) (H3113-009-0) Formulary Drugs Starting with the Letter C in Lebanon County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $19.00 Deductible: $405 |
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 PA cover CABERGOLINE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CABOMETYX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CABOMETYX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P Q:30 /30Days |
CABOMETYX 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CABOMETYX 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P Q:60 /30Days |
CABOMETYX 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CABOMETYX 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P Q:30 /30Days |
CALCIPOTRIENE 0.005% CREAM ![Compare how all Medicare Part D PDP plans in PA cover CALCIPOTRIENE 0.005% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CALCIPOTRIENE 0.005% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover CALCIPOTRIENE 0.005% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in PA cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:4 /28Days |
CALCITRIOL 0.25 MCG CAPSULE [Rocaltrol] ![Compare how all Medicare Part D PDP plans in PA cover CALCITRIOL 0.25 MCG CAPSULE [Rocaltrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | P |
CALCITRIOL 0.5 MCG CAPSULE [Rocaltrol] ![Compare how all Medicare Part D PDP plans in PA cover CALCITRIOL 0.5 MCG CAPSULE [Rocaltrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | P |
Calcitriol 1 MCG per 1 ML Injection ![Compare how all Medicare Part D PDP plans in PA cover Calcitriol 1 MCG per 1 ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CALCITRIOL 1MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in PA cover CALCITRIOL 1MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | P |
CALCITRIOL 3 MCG/G OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover CALCITRIOL 3 MCG/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CALCIUM ACETATE 667 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CALCIUM ACETATE 667 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CALCIUM ACETATE CAPSULE 667 MG ![Compare how all Medicare Part D PDP plans in PA cover CALCIUM ACETATE CAPSULE 667 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Calcium Chloride 0.002 MEQ/ML / Potassium Chloride 0.004 MEQ/ML / Sodium Chloride 0.147 MEQ/ML Injec ![Compare how all Medicare Part D PDP plans in PA cover Calcium Chloride 0.002 MEQ/ML / Potassium Chloride 0.004 MEQ/ML / Sodium Chloride 0.147 MEQ/ML Injec.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CALQUENCE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CALQUENCE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P Q:60 /30Days |
CAMILA 0.35 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAMILA 0.35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CAMRESE LO TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAMRESE LO TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CANASA 1,000 MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in PA cover CANASA 1,000 MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CANCIDAS IV 50MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CANCIDAS IV 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CANCIDAS IV 70MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CANCIDAS IV 70MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CANDESARTAN CILEXETIL 16 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PA cover CANDESARTAN CILEXETIL 16 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:30 /30Days |
CANDESARTAN CILEXETIL 32 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PA cover CANDESARTAN CILEXETIL 32 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:30 /30Days |
CANDESARTAN CILEXETIL 4 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PA cover CANDESARTAN CILEXETIL 4 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:30 /30Days |
CANDESARTAN CILEXETIL 8 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in PA cover CANDESARTAN CILEXETIL 8 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:90 /30Days |
candesartan-hctz 16-12.5 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover candesartan-hctz 16-12.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:30 /30Days |
candesartan-hctz 32-12.5 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover candesartan-hctz 32-12.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:30 /30Days |
CANDESARTAN-HCTZ 32-25 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover CANDESARTAN-HCTZ 32-25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:30 /30Days |
CAPASTAT SULFATE 1g/1 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in PA cover CAPASTAT SULFATE 1g/1 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CAPRELSA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAPRELSA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CAPRELSA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAPRELSA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CAPTOPRIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAPTOPRIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAPTOPRIL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAPTOPRIL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:90 /30Days |
CAPTOPRIL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAPTOPRIL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:90 /30Days |
CAPTOPRIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAPTOPRIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:270 /30Days |
Captopril and Hydrochlorothiazide 25; 15mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Captopril and Hydrochlorothiazide 25; 15mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:90 /30Days |
Captopril and Hydrochlorothiazide 25; 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Captopril and Hydrochlorothiazide 25; 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:60 /30Days |
Captopril and Hydrochlorothiazide 50; 15mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Captopril and Hydrochlorothiazide 50; 15mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:90 /30Days |
Captopril and Hydrochlorothiazide 50; 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Captopril and Hydrochlorothiazide 50; 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | Q:60 /30Days |
CARAC CREAM ![Compare how all Medicare Part D PDP plans in PA cover CARAC CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CARAFATE SUS 1GM/10ML ![Compare how all Medicare Part D PDP plans in PA cover CARAFATE SUS 1GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARBAGLU 200 MG DISPER TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARBAGLU 200 MG DISPER TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CARBAMAZEPINE 100 MG TAB CHEW ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE 100 MG TAB CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBAMAZEPINE 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE ER 100 MG CAP CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE ER 100 MG CAP CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE ER 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE ER 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE ER 200 MG CAP CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE ER 200 MG CAP CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE ER 300 MG CAP CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE ER 300 MG CAP CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE XR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE XR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CARBAMAZEPINE XR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARBAMAZEPINE XR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Carbidopa 25mg Tab 100 [Lodosyn] ![Compare how all Medicare Part D PDP plans in PA cover Carbidopa 25mg Tab 100 [Lodosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARBIDOPA AND LEVODOPA ODT 25;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA AND LEVODOPA ODT 25;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA AND LEVODOPA ODT 25;250MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA AND LEVODOPA ODT 25;250MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARBIDOPA-LEVO ER 25-100 TAB ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVO ER 25-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARBIDOPA-LEVO ER 50-200 TAB ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVO ER 50-200 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA 10-100 TAB ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA 10-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA 25-100 TAB ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA 25-100 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA 25-250 TAB ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA 25-250 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA-ENTA 150 MG ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA-ENTA 150 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA-ENTA 75 MG ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA-ENTA 75 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA-ENTACAPONE 100 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA-ENTACAPONE 100 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA-ENTACAPONE 125 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA-ENTACAPONE 125 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARBIDOPA-LEVODOPA-ENTACAPONE 200 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA-ENTACAPONE 200 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA-LEVODOPA-ENTACAPONE 50 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in PA cover CARBIDOPA-LEVODOPA-ENTACAPONE 50 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Carboplatin 10 MG/ML Injectable Solution ![Compare how all Medicare Part D PDP plans in PA cover Carboplatin 10 MG/ML Injectable Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARDENE-NACL 20 MG/200 ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover CARDENE-NACL 20 MG/200 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARDENE-NACL 40 MG/200 ML IV ![Compare how all Medicare Part D PDP plans in PA cover CARDENE-NACL 40 MG/200 ML IV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CARIMUNE NF 6GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CARIMUNE NF 6GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CARTEOLOL HCL 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover CARTEOLOL HCL 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PA cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PA cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PA cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARTIA XT 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CARTIA XT 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CARVEDILOL 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARVEDILOL 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARVEDILOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARVEDILOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARVEDILOL 3.125 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARVEDILOL 3.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CARVEDILOL 6.25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CARVEDILOL 6.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CASPOFUNGIN ACETATE 50 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CASPOFUNGIN ACETATE 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CASPOFUNGIN ACETATE 70 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CASPOFUNGIN ACETATE 70 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CAYSTON KIT 75 MG/VIAL ![Compare how all Medicare Part D PDP plans in PA cover CAYSTON KIT 75 MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CAZIANT 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in PA cover CAZIANT 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFACLOR 250 MG CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover CEFACLOR 250 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEFACLOR 500 MG CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover CEFACLOR 500 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEFADROXIL 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFADROXIL 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEFADROXIL 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CEFADROXIL 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFADROXIL 500 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFADROXIL 500 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEFAZOLIN 1 GM VIAL 25/Box ![Compare how all Medicare Part D PDP plans in PA cover CEFAZOLIN 1 GM VIAL 25/Box.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE ![Compare how all Medicare Part D PDP plans in PA cover Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFAZOLIN 500 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFAZOLIN 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFDINIR 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFDINIR 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFDINIR 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFDINIR 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFDINIR 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CEFDINIR 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFEPIME HCL 1 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFEPIME HCL 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFEPIME HCL 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFEPIME HCL 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFIXIME 100 MG/5 ML SUSP [Suprax] ![Compare how all Medicare Part D PDP plans in PA cover CEFIXIME 100 MG/5 ML SUSP [Suprax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFIXIME 200 MG/5 ML SUSP [Suprax] ![Compare how all Medicare Part D PDP plans in PA cover CEFIXIME 200 MG/5 ML SUSP [Suprax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cefotaxime 500 MG Injection ![Compare how all Medicare Part D PDP plans in PA cover Cefotaxime 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cefotaxime sodium 1 gm vial ![Compare how all Medicare Part D PDP plans in PA cover Cefotaxime sodium 1 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cefotaxime sodium 2 gm vial ![Compare how all Medicare Part D PDP plans in PA cover Cefotaxime sodium 2 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFOTETAN 1GM VIAL 1EA x 10 ![Compare how all Medicare Part D PDP plans in PA cover CEFOTETAN 1GM VIAL 1EA x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFOTETAN 2GM VIAL 1EA x 10 ![Compare how all Medicare Part D PDP plans in PA cover CEFOTETAN 2GM VIAL 1EA x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFOXITIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFOXITIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFOXITIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFOXITIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFOXITIN 2 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFOXITIN 2 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFPODOXIME 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CEFPODOXIME 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFPODOXIME 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFPODOXIME 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFPODOXIME 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CEFPODOXIME 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFPODOXIME 50 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFPODOXIME 50 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFPROZIL 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFPROZIL 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFPROZIL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CEFPROZIL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFPROZIL 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEFPROZIL 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFPROZIL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CEFPROZIL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CEFTAZIDIME 1 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFTAZIDIME 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN ![Compare how all Medicare Part D PDP plans in PA cover CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN ![Compare how all Medicare Part D PDP plans in PA cover CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFTRIAXONE 1 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFTRIAXONE 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFTRIAXONE 10 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFTRIAXONE 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFTRIAXONE 2 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFTRIAXONE 2 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFTRIAXONE 250 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFTRIAXONE 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFTRIAXONE 500 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEFTRIAXONE 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFUROXIME 1.5 GM/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover CEFUROXIME 1.5 GM/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFUROXIME 750 MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover CEFUROXIME 750 MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cefuroxime 95 MG/ML Injectable Solution ![Compare how all Medicare Part D PDP plans in PA cover Cefuroxime 95 MG/ML Injectable Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEFUROXIME AXETIL 250 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover CEFUROXIME AXETIL 250 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEFUROXIME AXETIL 500 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover CEFUROXIME AXETIL 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CELECOXIB 100 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PA cover CELECOXIB 100 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:60 /30Days |
CELECOXIB 200 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PA cover CELECOXIB 200 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:60 /30Days |
CELECOXIB 400 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PA cover CELECOXIB 400 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:60 /30Days |
CELECOXIB 50 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in PA cover CELECOXIB 50 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CELLCEPT 200 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in PA cover CELLCEPT 200 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CELLCEPT 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CELLCEPT 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CELLCEPT 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CELLCEPT 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CELONTIN 300 MG KAPSEAL ![Compare how all Medicare Part D PDP plans in PA cover CELONTIN 300 MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CEPHALEXIN 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEPHALEXIN 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEPHALEXIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CEPHALEXIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEPHALEXIN 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover CEPHALEXIN 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEPHALEXIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CEPHALEXIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEPHALEXIN 750 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CEPHALEXIN 750 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CEREZYME 400 UNITS VIAL ![Compare how all Medicare Part D PDP plans in PA cover CEREZYME 400 UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CESAMET 1 MG CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover CESAMET 1 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CETIRIZINE HCL 1 MG/ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover CETIRIZINE HCL 1 MG/ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHANTIX 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHANTIX 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CHANTIX 1 MG CONT MONTH BOX ![Compare how all Medicare Part D PDP plans in PA cover CHANTIX 1 MG CONT MONTH BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CHANTIX 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHANTIX 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CHANTIX STARTING MONTH BOX ![Compare how all Medicare Part D PDP plans in PA cover CHANTIX STARTING MONTH BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CHEMET 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CHEMET 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CHENODAL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHENODAL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CHLORAMPHEN NA SUCC 1GM VL ![Compare how all Medicare Part D PDP plans in PA cover CHLORAMPHEN NA SUCC 1GM VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHLORDIAZEPOXIDE 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CHLORDIAZEPOXIDE 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLORDIAZEPOXIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CHLORDIAZEPOXIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLORDIAZEPOXIDE 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CHLORDIAZEPOXIDE 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORHEXIDINE GLUCONATE 0.12% RINSE ![Compare how all Medicare Part D PDP plans in PA cover CHLORHEXIDINE GLUCONATE 0.12% RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLOROQUINE PH 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLOROQUINE PH 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLOROQUINE PH 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLOROQUINE PH 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLOROTHIAZIDE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLOROTHIAZIDE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Chlorothiazide 500 MG Injection ![Compare how all Medicare Part D PDP plans in PA cover Chlorothiazide 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
Chlorothiazide 500mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Chlorothiazide 500mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLORPROMAZINE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORPROMAZINE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHLORPROMAZINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORPROMAZINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHLORPROMAZINE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORPROMAZINE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHLORPROMAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORPROMAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHLORPROMAZINE 25 MG/ML AMP ![Compare how all Medicare Part D PDP plans in PA cover CHLORPROMAZINE 25 MG/ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORPROMAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORPROMAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHLORTHALIDONE 25 MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover CHLORTHALIDONE 25 MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLORTHALIDONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORTHALIDONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CHLORZOXAZONE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CHLORZOXAZONE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CHOLBAM 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CHOLBAM 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CHOLBAM 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CHOLBAM 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CHOLESTYRAMINE LIGHT POWDER ![Compare how all Medicare Part D PDP plans in PA cover CHOLESTYRAMINE LIGHT POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHOLESTYRAMINE PACKET ![Compare how all Medicare Part D PDP plans in PA cover CHOLESTYRAMINE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CHORIONIC GONAD 10000U VIAL ![Compare how all Medicare Part D PDP plans in PA cover CHORIONIC GONAD 10000U VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CICLOPIROX 0.77% CREAM ![Compare how all Medicare Part D PDP plans in PA cover CICLOPIROX 0.77% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CICLOPIROX 0.77% GEL ![Compare how all Medicare Part D PDP plans in PA cover CICLOPIROX 0.77% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CICLOPIROX 0.77% TOPICAL SUSP ![Compare how all Medicare Part D PDP plans in PA cover CICLOPIROX 0.77% TOPICAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CICLOPIROX 1% SHAMPOO ![Compare how all Medicare Part D PDP plans in PA cover CICLOPIROX 1% SHAMPOO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CICLOPIROX 8% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover CICLOPIROX 8% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CIDOFOVIR 375 MG/5 ML VIAL [Vistide] ![Compare how all Medicare Part D PDP plans in PA cover CIDOFOVIR 375 MG/5 ML VIAL [Vistide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
Cilastatin 250 MG / Imipenem 250 MG Injection ![Compare how all Medicare Part D PDP plans in PA cover Cilastatin 250 MG / Imipenem 250 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cilastatin 500 MG / Imipenem 500 MG Injection ![Compare how all Medicare Part D PDP plans in PA cover Cilastatin 500 MG / Imipenem 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CILOSTAZOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CILOSTAZOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CILOSTAZOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CILOSTAZOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CILOXAN 0.3% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover CILOXAN 0.3% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cimetidine 200mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Cimetidine 200mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Cimetidine 300 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in PA cover Cimetidine 300 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Cimetidine 400mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Cimetidine 400mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Cimetidine 800mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Cimetidine 800mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Cimetidine Hydrochloride Oral Solution 300mg/5mL 237 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Cimetidine Hydrochloride Oral Solution 300mg/5mL 237 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Cimzia 2 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in PA cover Cimzia 2 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CIMZIA 200 MG/ML SYRINGE KIT ![Compare how all Medicare Part D PDP plans in PA cover CIMZIA 200 MG/ML SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
Cinryze 500[iU]/5mL 1 VIAL per CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PA 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 |
Tier 5 |
$0.00 | N/A | P |
CIPRO HC OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover CIPRO HC OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CIPRODEX OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover CIPRODEX OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CIPROFLOXACIN 0.3% EYE DROP [Ciloxan] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN 0.3% EYE DROP [Ciloxan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CIPROFLOXACIN 250 MG TABLET (100 CT) [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN 250 MG TABLET (100 CT) [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CIPROFLOXACIN 250 MG/5 ML SUSP MC REC [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN 250 MG/5 ML SUSP MC REC [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPROFLOXACIN 500 MG/5 ML SUSP MC REC [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN 500 MG/5 ML SUSP MC REC [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CIPROFLOXACIN ER 1,000 MG TAB TBMP 24HR [Cipro XR] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN ER 1,000 MG TAB TBMP 24HR [Cipro XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CIPROFLOXACIN ER 500 MG TABLET TBMP 24HR [Proquin XR] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN ER 500 MG TABLET TBMP 24HR [Proquin XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CIPROFLOXACIN HCL 100 MG Tablet [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN HCL 100 MG Tablet [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CIPROFLOXACIN HCL 500 MG Tablet [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN HCL 500 MG Tablet [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CIPROFLOXACIN HCL 750 MG Tablet [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN HCL 750 MG Tablet [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CIPROFLOXACIN-D5W 200 MG/100 ML PIGGYBACK [Cipro] ![Compare how all Medicare Part D PDP plans in PA cover CIPROFLOXACIN-D5W 200 MG/100 ML PIGGYBACK [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CISPLATIN 50MG/50ML MDV ![Compare how all Medicare Part D PDP plans in PA cover CISPLATIN 50MG/50ML MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CITALOPRAM HBR 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CITALOPRAM HBR 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CITALOPRAM HBR 10 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover CITALOPRAM HBR 10 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CITALOPRAM HBR 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CITALOPRAM HBR 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CITALOPRAM HBR 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CITALOPRAM HBR 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
Cladribine 1 MG/ML in 10 ML Injection ![Compare how all Medicare Part D PDP plans in PA cover Cladribine 1 MG/ML in 10 ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CLARAVIS 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLARAVIS 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CLARAVIS 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLARAVIS 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
Claravis 30mg 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA 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 |
Tier 4 |
$0.00 | N/A | P |
CLARAVIS 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLARAVIS 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLARITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLARITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLARITHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLARITHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLARITHROMYCIN ER 500 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover CLARITHROMYCIN ER 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLIMARA PRO DIS WEEKLY 4.40MG/1.39MG ![Compare how all Medicare Part D PDP plans in PA cover CLIMARA PRO DIS WEEKLY 4.40MG/1.39MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Clindamycin 150 MG/ML 2ml ![Compare how all Medicare Part D PDP plans in PA cover Clindamycin 150 MG/ML 2ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLINDAMYCIN 150mg/ml vl 25x6ml ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN 150mg/ml vl 25x6ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLINDAMYCIN 75 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN 75 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLINDAMYCIN HCL 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN HCL 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLINDAMYCIN HCL 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN HCL 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLINDAMYCIN HCL 75 MG 200 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN HCL 75 MG 200 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLINDAMYCIN PH 1% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN PH 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLINDAMYCIN PH 600 MG/4 ML VL ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN PH 600 MG/4 ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLINDAMYCIN PHOSP 1% LOTION ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN PHOSP 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Clindamycin Phosphate and Benzoyl Peroxide 1 KIT ![Compare how all Medicare Part D PDP plans in PA cover Clindamycin Phosphate and Benzoyl Peroxide 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLINDAMYCIN PHOSPHATE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in PA cover CLINDAMYCIN PHOSPHATE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
Clindamycin-d5w 300 mg/50 ml ![Compare how all Medicare Part D PDP plans in PA cover Clindamycin-d5w 300 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Clindamycin-d5w 600 mg/50 ml ![Compare how all Medicare Part D PDP plans in PA cover Clindamycin-d5w 600 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Clindamycin-d5w 900 mg/50 ml ![Compare how all Medicare Part D PDP plans in PA cover Clindamycin-d5w 900 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLOBETASOL 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover CLOBETASOL 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLOBETASOL 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover CLOBETASOL 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLOBETASOL EMOLLIENT 0.05% CRM ![Compare how all Medicare Part D PDP plans in PA cover CLOBETASOL EMOLLIENT 0.05% CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Clobetasol Propionate 0.5 MG/ML Medicated Shampoo ![Compare how all Medicare Part D PDP plans in PA cover Clobetasol Propionate 0.5 MG/ML Medicated Shampoo.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | 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 PA cover CLOFARABINE 20 MG/20 ML VIAL [Clolar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CLOMIPRAMINE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLOMIPRAMINE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLOMIPRAMINE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLOMIPRAMINE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLOMIPRAMINE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CLOMIPRAMINE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLONAZEPAM 0.125 MG DIS TAB RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 0.125 MG DIS TAB RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:120 /30Days |
CLONAZEPAM 0.25 MG ODT TAB RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 0.25 MG ODT TAB RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:120 /30Days |
CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:120 /30Days |
CLONAZEPAM 0.5 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 0.5 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | Q:120 /30Days |
CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:120 /30Days |
CLONAZEPAM 1 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 1 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | Q:120 /30Days |
CLONAZEPAM 2 MG ODT TAB RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 2 MG ODT TAB RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | Q:300 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLONAZEPAM 2 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in PA cover CLONAZEPAM 2 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | 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 PA 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) |
4 |
Tier 4 |
$0.00 | 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 PA 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) |
4 |
Tier 4 |
$0.00 | 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 PA 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) |
4 |
Tier 4 |
$0.00 | N/A | None |
CLONIDINE HCL 0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLONIDINE HCL 0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CLONIDINE HCL 0.2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLONIDINE HCL 0.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CLONIDINE HCL 0.3 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLONIDINE HCL 0.3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | N/A | None |
CLONIDINE HCL ER 0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLONIDINE HCL ER 0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CLOPIDOGREL 75 MG TABLET [Plavix] ![Compare how all Medicare Part D PDP plans in PA cover CLOPIDOGREL 75 MG TABLET [Plavix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | Q:120 /30Days |
CLORAZEPATE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLORAZEPATE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | Q:180 /30Days |
CLORAZEPATE 3.75 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLORAZEPATE 3.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | Q:720 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLORAZEPATE 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLORAZEPATE 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | Q:360 /30Days |
CLOTRIMAZOLE 1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover CLOTRIMAZOLE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLOTRIMAZOLE 1% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover CLOTRIMAZOLE 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLOTRIMAZOLE 10 MG TROCHE ![Compare how all Medicare Part D PDP plans in PA cover CLOTRIMAZOLE 10 MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CLOTRIMAZOLE-BETAMETHASONE LOT ![Compare how all Medicare Part D PDP plans in PA cover CLOTRIMAZOLE-BETAMETHASONE LOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | 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 PA 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) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLOZAPINE 100 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE 100 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLOZAPINE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLOZAPINE 25 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE 25 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLOZAPINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CLOZAPINE ODT 100 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE ODT 100 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:270 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOZAPINE ODT 12.5 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE ODT 12.5 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:60 /30Days |
CLOZAPINE ODT 150 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE ODT 150 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:180 /30Days |
CLOZAPINE ODT 200 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE ODT 200 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | Q:120 /30Days |
CLOZAPINE ODT 25 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in PA cover CLOZAPINE ODT 25 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:90 /30Days |
COARTEM 20MG-120MG ![Compare how all Medicare Part D PDP plans in PA cover COARTEM 20MG-120MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CODEINE SULFATE 15 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover CODEINE SULFATE 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:180 /30Days |
CODEINE SULFATE 30 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover CODEINE SULFATE 30 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:180 /30Days |
CODEINE SULFATE 60 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover CODEINE SULFATE 60 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:180 /30Days |
COLCHICINE 0.6 MG CAPSULE [Mitigare] ![Compare how all Medicare Part D PDP plans in PA cover COLCHICINE 0.6 MG CAPSULE [Mitigare].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:120 /30Days |
COLCHICINE 0.6 MG TABLET [Colcrys] ![Compare how all Medicare Part D PDP plans in PA cover COLCHICINE 0.6 MG TABLET [Colcrys].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:120 /30Days |
COLCRYS 0.6 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COLCRYS 0.6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COLESEVELAM 625 MG TABLET [WelChol] ![Compare how all Medicare Part D PDP plans in PA cover COLESEVELAM 625 MG TABLET [WelChol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
COLESTIPOL HCL 1G TABLET ![Compare how all Medicare Part D PDP plans in PA cover COLESTIPOL HCL 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
COLESTIPOL HCL GRANULES PACKET ![Compare how all Medicare Part D PDP plans in PA cover COLESTIPOL HCL GRANULES PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COLISTIMETHATE 150 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover COLISTIMETHATE 150 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COLOCORT 100MG ENEMA ![Compare how all Medicare Part D PDP plans in PA cover COLOCORT 100MG ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COLY-MYCIN S OTIC SUSP DROP ![Compare how all Medicare Part D PDP plans in PA cover COLY-MYCIN S OTIC SUSP DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COMBIGAN 0.2%-0.5% DROPS ![Compare how all Medicare Part D PDP plans in PA cover COMBIGAN 0.2%-0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
COMBIVENT RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in PA cover COMBIVENT RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
COMBIVIR TABLET ![Compare how all Medicare Part D PDP plans in PA cover COMBIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | Q:90 /30Days |
COMETRIQ 100 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in PA cover COMETRIQ 100 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
COMETRIQ 140 MG DAILY-DOSE PK ![Compare how all Medicare Part D PDP plans in PA cover COMETRIQ 140 MG DAILY-DOSE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COMETRIQ 60 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in PA cover COMETRIQ 60 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in PA cover COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | Q:60 /30Days |
COMPRO 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in PA cover COMPRO 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CONSTULOSE 10 GM/15 ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover CONSTULOSE 10 GM/15 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN ![Compare how all Medicare Part D PDP plans in PA cover COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
COPAXONE 40 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover COPAXONE 40 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CORDRAN 4 MCG/SQ CM TAPE LARGE ![Compare how all Medicare Part D PDP plans in PA cover CORDRAN 4 MCG/SQ CM TAPE LARGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CORLANOR 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CORLANOR 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P Q:60 /30Days |
CORLANOR 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CORLANOR 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P Q:60 /30Days |
Cortisone 25 MG Tablet ![Compare how all Medicare Part D PDP plans in PA cover Cortisone 25 MG Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CORTISPORIN CRE 0.5% ![Compare how all Medicare Part D PDP plans in PA cover CORTISPORIN CRE 0.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CORTISPORIN OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover CORTISPORIN OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COSENTYX 300 MG DOSE-2 PENS ![Compare how all Medicare Part D PDP plans in PA cover COSENTYX 300 MG DOSE-2 PENS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
COSMEGEN 0.5 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover COSMEGEN 0.5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
COSOPT PF EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover COSOPT PF EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COTELLIC 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COTELLIC 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P Q:90 /30Days |
COUMADIN 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 3mg/1 1 BOTTLE per CARTON / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 3mg/1 1 BOTTLE per CARTON / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 4mg/1 1 BOTTLE in 1 CARTON / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 4mg/1 1 BOTTLE in 1 CARTON / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COUMADIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 6MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
COUMADIN 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover COUMADIN 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | 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 PA 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) |
3 |
Tier 3 |
$0.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CREON DR 36,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CREON DR 36,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | None |
CRINONE 4% GEL ![Compare how all Medicare Part D PDP plans in PA cover CRINONE 4% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CRINONE 8% GEL ![Compare how all Medicare Part D PDP plans in PA cover CRINONE 8% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:270 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CRIXIVAN 400mg, 180 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover CRIXIVAN 400mg, 180 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | Q:270 /30Days |
CROMOLYN 20 MG/2 ML NEB SOLN ![Compare how all Medicare Part D PDP plans in PA cover CROMOLYN 20 MG/2 ML NEB SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
CROMOLYN SODIUM 100 MG/5 ML ![Compare how all Medicare Part D PDP plans in PA cover CROMOLYN SODIUM 100 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CROMOLYN SODIUM 4% 40MG 10ML BOT ![Compare how all Medicare Part D PDP plans in PA cover CROMOLYN SODIUM 4% 40MG 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CUBICIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover CUBICIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CUPRIMINE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CUPRIMINE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CUVPOSA 1 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover CUVPOSA 1 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
Cyclafem 1/35 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover Cyclafem 1/35 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYCLAFEM 7-7-7-28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover CYCLAFEM 7-7-7-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYCLOBENZAPRINE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CYCLOBENZAPRINE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
CYCLOBENZAPRINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CYCLOBENZAPRINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$0.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOBENZAPRINE 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CYCLOBENZAPRINE 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYCLOPHOSPHAMIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CYCLOPHOSPHAMIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CYCLOPHOSPHAMIDE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CYCLOPHOSPHAMIDE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CYCLOSET 0.8MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSET 0.8MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P Q:180 /30Days |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
Cyclosporine 50 mg/ml vial ![Compare how all Medicare Part D PDP plans in PA cover Cyclosporine 50 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYCLOSPORINE MODIFIED 100 MG ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSPORINE MODIFIED 100 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
CYCLOSPORINE MODIFIED 25 MG ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSPORINE MODIFIED 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
CYCLOSPORINE MODIFIED 50 MG ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSPORINE MODIFIED 50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT ![Compare how all Medicare Part D PDP plans in PA cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$0.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYPROHEPTADINE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover CYPROHEPTADINE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL ![Compare how all Medicare Part D PDP plans in PA cover CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYRAMZA 100 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover CYRAMZA 100 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CYRAMZA 500 MG/50 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover CYRAMZA 500 MG/50 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | P |
CYSTADANE 1 GRAM/1.7 ML POWDER ![Compare how all Medicare Part D PDP plans in PA cover CYSTADANE 1 GRAM/1.7 ML POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | None |
CYSTARAN 0.44% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover CYSTARAN 0.44% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
$0.00 | N/A | None |
CYTARABINE 20MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover CYTARABINE 20MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |
CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover CYTARABINE SOLUTION INJECTION 100MG 20ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$0.00 | N/A | P |