2018 Medicare Part D Plan Formulary Information |
Anthem Blue MedicareRx Plus (PDP) (S5596-001-0)
Benefit Details
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The Anthem Blue MedicareRx Plus (PDP) (S5596-001-0) Formulary Drugs Starting with the Letter A in CMS PDP Region 01 which includes: ME NH Plan Monthly Premium: $94.00 Deductible: $0 Qualifies for LIS: No |
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ABACAVIR 20 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover ABACAVIR 20 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:960 /30Days |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:60 /30Days |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in NH cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ABACAVIR-LAMIVUDINE 600-300 MG ![Compare how all Medicare Part D PDP plans in NH cover ABACAVIR-LAMIVUDINE 600-300 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
ABELCET INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in NH cover ABELCET INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ABILIFY MAINTENA ER 300 MG SYR ![Compare how all Medicare Part D PDP plans in NH cover ABILIFY MAINTENA ER 300 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 300 MG VL ![Compare how all Medicare Part D PDP plans in NH cover ABILIFY MAINTENA ER 300 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 400 MG SUSER VIAL ![Compare how all Medicare Part D PDP plans in NH cover ABILIFY MAINTENA ER 400 MG SUSER VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 400 MG SYR ![Compare how all Medicare Part D PDP plans in NH cover ABILIFY MAINTENA ER 400 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /28Days |
ABRAXANE 100MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover ABRAXANE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in NH cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ACARBOSE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACARBOSE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:90 /30Days |
ACARBOSE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACARBOSE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:360 /30Days |
ACARBOSE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACARBOSE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:180 /30Days |
ACEBUTOLOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ACEBUTOLOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ACEBUTOLOL 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ACEBUTOLOL 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ACETAMINOP-CODEINE 120-12 MG/5 ![Compare how all Medicare Part D PDP plans in NH cover ACETAMINOP-CODEINE 120-12 MG/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:4500 /30Days |
ACETAMINOPHEN-COD #2 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACETAMINOPHEN-COD #2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:390 /30Days |
ACETAMINOPHEN-COD #3 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACETAMINOPHEN-COD #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:360 /30Days |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:180 /30Days |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
Acetazolamide 500mg/5mL 1 VIAL in 1 CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NH cover Acetazolamide 500mg/5mL 1 VIAL in 1 CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ACETAZOLAMIDE ER 500 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover ACETAZOLAMIDE ER 500 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ACETIC ACID 2% EAR SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover ACETIC ACID 2% EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in NH cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P |
Acetylcysteine 200 MG/ML Inhalant Solution ![Compare how all Medicare Part D PDP plans in NH cover Acetylcysteine 200 MG/ML Inhalant Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in NH cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in NH cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in NH cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ACTHIB VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in NH cover ACTHIB VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACYCLOVIR 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ACYCLOVIR 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ACYCLOVIR 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover ACYCLOVIR 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ACYCLOVIR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACYCLOVIR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
Acyclovir 5% Ointment ![Compare how all Medicare Part D PDP plans in NH cover Acyclovir 5% Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:30 /30Days |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in NH cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ADACEL TDAP SYRINGE ![Compare how all Medicare Part D PDP plans in NH cover ADACEL TDAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in NH cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in NH cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:2 /28Days |
ADAPALENE 0.1% GEL ![Compare how all Medicare Part D PDP plans in NH cover ADAPALENE 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera] ![Compare how all Medicare Part D PDP plans in NH cover ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Adriamycin 20 mg/10 ml vial ![Compare how all Medicare Part D PDP plans in NH cover Adriamycin 20 mg/10 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ADRUCIL 50mg/mL 10 VIAL in 1 TRAY / 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NH cover ADRUCIL 50mg/mL 10 VIAL in 1 TRAY / 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in NH cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in NH cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in NH cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in NH cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:12 /30Days |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in NH cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:12 /30Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in NH cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:12 /30Days |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in NH cover Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in NH cover AFINITOR TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AFINITOR TABLETS 2.5 MG ![Compare how all Medicare Part D PDP plans in NH cover AFINITOR TABLETS 2.5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in NH cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Ala-cort 2.5% cream ![Compare how all Medicare Part D PDP plans in NH cover Ala-cort 2.5% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ALBENZA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALBENZA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ALBUTEROL SUL 2.5 MG/3 ML SOLN ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SUL 2.5 MG/3 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P Q:360 /30Days |
ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P Q:360 /30Days |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P Q:360 /30Days |
ALBUTEROL SULFATE 2 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE 2 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ALBUTEROL SULFATE 4 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE 4 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in NH cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ALCLOMETASONE DIPR 0.05% OINT ![Compare how all Medicare Part D PDP plans in NH cover ALCLOMETASONE DIPR 0.05% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ALCLOMETASONE DIPRO 0.05% CRM ![Compare how all Medicare Part D PDP plans in NH cover ALCLOMETASONE DIPRO 0.05% CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ALECENSA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ALECENSA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:240 /30Days |
ALENDRONATE SODIUM 10 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover ALENDRONATE SODIUM 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | Q:30 /30Days |
ALENDRONATE SODIUM 35 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover ALENDRONATE SODIUM 35 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | Q:4 /28Days |
ALENDRONATE SODIUM 40 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALENDRONATE SODIUM 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | Q:30 /30Days |
ALENDRONATE SODIUM 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALENDRONATE SODIUM 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | Q:30 /30Days |
ALENDRONATE SODIUM 70 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover ALENDRONATE SODIUM 70 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | Q:4 /28Days |
ALENDRONATE SODIUM 70 MG/75 ML ![Compare how all Medicare Part D PDP plans in NH cover ALENDRONATE SODIUM 70 MG/75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:300 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALFUZOSIN HCL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALFUZOSIN HCL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ALIMTA 100 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover ALIMTA 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ALIMTA 500 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover ALIMTA 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ALINIA 100 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover ALINIA 100 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:180 /30Days |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:6 /30Days |
ALIQOPA 60 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover ALIQOPA 60 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ALLOPURINOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALLOPURINOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ALLOPURINOL 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALLOPURINOL 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
Allopurinol sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in NH cover Allopurinol sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ALOPRIM SOLUTION FOR INJECTION 500MG/VIAL 30 ML VIALGL ![Compare how all Medicare Part D PDP plans in NH cover ALOPRIM SOLUTION FOR INJECTION 500MG/VIAL 30 ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ALOSETRON HCL 0.5 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in NH cover ALOSETRON HCL 0.5 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALOSETRON HCL 1 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in NH cover ALOSETRON HCL 1 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in NH cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ALPRAZOLAM 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALPRAZOLAM 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:120 /30Days |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:120 /30Days |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:120 /30Days |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:120 /30Days |
ALTAVERA-28 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALTAVERA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ALUNBRIG 180 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALUNBRIG 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
ALUNBRIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALUNBRIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:180 /30Days |
ALUNBRIG 90 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALUNBRIG 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
ALUNBRIG 90 MG-180 MG TABLET PACK ![Compare how all Medicare Part D PDP plans in NH cover ALUNBRIG 90 MG-180 MG TABLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /180Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALYACEN 1-35-28 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ALYACEN 1-35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMANTADINE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover AMANTADINE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMANTADINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMANTADINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMANTADINE 50 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover AMANTADINE 50 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMBISOME 50MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover AMBISOME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMCINONIDE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in NH cover AMCINONIDE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMCINONIDE 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMIKACIN SULF 500 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover AMIKACIN SULF 500 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMILORIDE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMILORIDE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMILORIDE HCL-HCTZ 5-50 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMILORIDE HCL-HCTZ 5-50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10] ![Compare how all Medicare Part D PDP plans in NH cover Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amino acids 4.25% in dextrose 20% Injectable Solution [Clinimix 4.25/20] ![Compare how all Medicare Part D PDP plans in NH cover Amino acids 4.25% in dextrose 20% Injectable Solution [Clinimix 4.25/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5] ![Compare how all Medicare Part D PDP plans in NH cover Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
Amino acids 4.25% with electrolytes in dextrose 10% Injectable Solution [Clinimix E 4.25/10] ![Compare how all Medicare Part D PDP plans in NH cover Amino acids 4.25% with electrolytes in dextrose 10% Injectable Solution [Clinimix E 4.25/10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
Aminophylline 25 MG/ML 10 ML Injection ![Compare how all Medicare Part D PDP plans in NH cover Aminophylline 25 MG/ML 10 ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMINOSYN 7%-ELECTROLYTE SOL ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN 7%-ELECTROLYTE SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN HBC INJECTION SULFITE FREE 7% ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN HBC INJECTION SULFITE FREE 7%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN II 10% SOL 6X2000 ML ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN II 10% SOL 6X2000 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN II 8.5% ELECTROLYT ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN II 8.5% ELECTROLYT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5% ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN WITH ELECTROLYTES SULFITE FREE INJECTION 8.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMINOSYN-RF 5.2% IV SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover AMINOSYN-RF 5.2% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMIODARONE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMIODARONE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMIODARONE HCL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMIODARONE HCL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMIODARONE HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMIODARONE HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMIODARONE HCL 50 MG/ML in 3 ML Injection ![Compare how all Medicare Part D PDP plans in NH cover AMIODARONE HCL 50 MG/ML in 3 ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in NH cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
AMITRIPTYLINE HCL 10 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMITRIPTYLINE HCL 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMITRIPTYLINE HCL 100 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMITRIPTYLINE HCL 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL 150 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMITRIPTYLINE HCL 150 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMITRIPTYLINE HCL 25 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMITRIPTYLINE HCL 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMITRIPTYLINE HCL 50 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMITRIPTYLINE HCL 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMITRIPTYLINE HCL 75 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMITRIPTYLINE HCL 75 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMLOD-VALSA-HCTZ 10-160-12.5MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in NH cover AMLOD-VALSA-HCTZ 10-160-12.5MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLOD-VALSA-HCTZ 10-160-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in NH cover AMLOD-VALSA-HCTZ 10-160-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLOD-VALSA-HCTZ 10-320-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in NH cover AMLOD-VALSA-HCTZ 10-320-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLOD-VALSA-HCTZ 5-160-12.5 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in NH cover AMLOD-VALSA-HCTZ 5-160-12.5 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLOD-VALSA-HCTZ 5-160-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in NH cover AMLOD-VALSA-HCTZ 5-160-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLODIPINE BESYLATE 10 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE BESYLATE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
AMLODIPINE BESYLATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE BESYLATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE BESYLATE 5 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE BESYLATE 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
AMLODIPINE-BENAZEPRIL 10-20 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-BENAZEPRIL 10-20 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-BENAZEPRIL 10-40 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-BENAZEPRIL 10-40 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-BENAZEPRIL 2.5-10 Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-BENAZEPRIL 2.5-10 Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-BENAZEPRIL 5-10 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-BENAZEPRIL 5-10 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-BENAZEPRIL 5-20 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-BENAZEPRIL 5-20 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-BENAZEPRIL 5-40 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-BENAZEPRIL 5-40 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-OLMESARTAN 10-20 MG [Azor] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-OLMESARTAN 10-20 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLODIPINE-OLMESARTAN 10-40 MG [Azor] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-OLMESARTAN 10-40 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLODIPINE-OLMESARTAN 5-20 MG [Azor] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-OLMESARTAN 5-20 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLODIPINE-OLMESARTAN 5-40 MG [Azor] ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-OLMESARTAN 5-40 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE-VALSARTAN 10-160 MG ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-VALSARTAN 10-160 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-VALSARTAN 10-320 MG ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-VALSARTAN 10-320 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AMLODIPINE-VALSARTAN 5-160 MG ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-VALSARTAN 5-160 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMLODIPINE-VALSARTAN 5-320 MG ![Compare how all Medicare Part D PDP plans in NH cover AMLODIPINE-VALSARTAN 5-320 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMMONIUM LACTATE 12% CREAM ![Compare how all Medicare Part D PDP plans in NH cover AMMONIUM LACTATE 12% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in NH cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in NH cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NH cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in NH cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX-CLAV 200-28.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV 200-28.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX-CLAV 250-62.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV 250-62.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOX-CLAV 400-57 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV 400-57 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX-CLAV 500-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV 500-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX-CLAV 600-42.9 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV 600-42.9 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX-CLAV 875-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV 875-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NH cover AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 250 MG TAB CHEW ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 250 MG TAB CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 400 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 400 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMOXICILLIN 875 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMOXICILLIN 875 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:90 /30Days |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:90 /30Days |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALTS 5 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover AMPHETAMINE SALTS 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:90 /30Days |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NH cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AMPICILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in NH cover AMPICILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Ampicillin 1000 MG / Sulbactam 500 MG Injection ![Compare how all Medicare Part D PDP plans in NH cover Ampicillin 1000 MG / Sulbactam 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Ampicillin 1000 MG Injection ![Compare how all Medicare Part D PDP plans in NH cover Ampicillin 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in NH cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Ampicillin 2000 MG / Sulbactam 1000 MG Injection ![Compare how all Medicare Part D PDP plans in NH cover Ampicillin 2000 MG / Sulbactam 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AMPICILLIN-SULBACTAM 15 GM VL ![Compare how all Medicare Part D PDP plans in NH cover AMPICILLIN-SULBACTAM 15 GM VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AMPYRA ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AMPYRA ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
ANADROL-50 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ANADROL-50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
ANASTROZOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ANASTROZOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | Q:30 /30Days |
ANDROGEL 1.62% (1.25G) GEL PCKT ![Compare how all Medicare Part D PDP plans in NH cover ANDROGEL 1.62% (1.25G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:113 /30Days |
ANDROGEL 1.62% (2.5G) GEL PCKT ![Compare how all Medicare Part D PDP plans in NH cover ANDROGEL 1.62% (2.5G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:150 /30Days |
Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in NH cover Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P Q:150 /30Days |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in NH cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
Antineoplastic Agent Etoposide 20 mg / mL Intravenous Injection Multiple Dose Vial 5 mL ![Compare how all Medicare Part D PDP plans in NH cover Antineoplastic Agent Etoposide 20 mg / mL Intravenous Injection Multiple Dose Vial 5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in NH cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Apraclonidine 5 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in NH cover Apraclonidine 5 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
APREPITANT 125 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in NH cover APREPITANT 125 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:5 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APREPITANT 125-80-80 MG PACK [Emend] ![Compare how all Medicare Part D PDP plans in NH cover APREPITANT 125-80-80 MG PACK [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:15 /30Days |
APREPITANT 40 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in NH cover APREPITANT 40 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:1 /28Days |
APREPITANT 80 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in NH cover APREPITANT 80 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:10 /30Days |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in NH cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
APRISO CP24 ![Compare how all Medicare Part D PDP plans in NH cover APRISO CP24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | S |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | S |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | S |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | S |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:120 /30Days |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in NH cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:380 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in NH cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in NH cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:900 /30Days |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:90 /30Days |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:60 /30Days |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:450 /30Days |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:180 /30Days |
ARIPIPRAZOLE ODT 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE ODT 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:90 /30Days |
ARIPIPRAZOLE ODT 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NH cover ARIPIPRAZOLE ODT 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARNUITY ELLIPTA 100 MCG INH ![Compare how all Medicare Part D PDP plans in NH cover ARNUITY ELLIPTA 100 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:30 /30Days |
ARNUITY ELLIPTA 200 MCG INH ![Compare how all Medicare Part D PDP plans in NH cover ARNUITY ELLIPTA 200 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:30 /30Days |
ARNUITY ELLIPTA 50 MCG INH BLST W/DEV ![Compare how all Medicare Part D PDP plans in NH cover ARNUITY ELLIPTA 50 MCG INH BLST W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:30 /30Days |
ARRANON 250 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover ARRANON 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ASACOL HD DR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ASACOL HD DR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Aspirin-Diphenhydramine ER 25-200 MG ![Compare how all Medicare Part D PDP plans in NH cover Aspirin-Diphenhydramine ER 25-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | S Q:60 /30Days |
ASTAGRAF XL 0.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ASTAGRAF XL 0.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ASTAGRAF XL 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ASTAGRAF XL 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ASTAGRAF XL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover ASTAGRAF XL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
ATAZANAVIR SULFATE 150 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in NH cover ATAZANAVIR SULFATE 150 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ATAZANAVIR SULFATE 200 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in NH cover ATAZANAVIR SULFATE 200 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATAZANAVIR SULFATE 300 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in NH cover ATAZANAVIR SULFATE 300 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
ATENOLOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ATENOLOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ATENOLOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ATENOLOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ATENOLOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover ATENOLOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in NH cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
ATOMOXETINE HCL 10 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 10 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:60 /30Days |
ATOMOXETINE HCL 100 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 100 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:30 /30Days |
ATOMOXETINE HCL 18 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 18 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:60 /30Days |
ATOMOXETINE HCL 25 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 25 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:60 /30Days |
ATOMOXETINE HCL 40 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 40 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATOMOXETINE HCL 60 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 60 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:30 /30Days |
ATOMOXETINE HCL 80 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NH cover ATOMOXETINE HCL 80 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P Q:30 /30Days |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NH cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NH cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NH cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NH cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$0.00 | N/A | None |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in NH cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in NH cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ATOVAQUONE-PROGUANIL 62.5-25 [Malarone] ![Compare how all Medicare Part D PDP plans in NH cover ATOVAQUONE-PROGUANIL 62.5-25 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
ATROPINE 0.05MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in NH cover ATROPINE 0.05MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATROPINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NH cover ATROPINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in NH cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | Q:26 /30Days |
AUGMENTIN 125-31.25 MG/5 ML ![Compare how all Medicare Part D PDP plans in NH cover AUGMENTIN 125-31.25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AVASTIN 400 MG/16 ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover AVASTIN 400 MG/16 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AVELOX IV 400 MG/250 ML ![Compare how all Medicare Part D PDP plans in NH cover AVELOX IV 400 MG/250 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Azacitidine 100 mg vial [Vidaza] ![Compare how all Medicare Part D PDP plans in NH cover Azacitidine 100 mg vial [Vidaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
AZASITE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NH cover AZASITE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AZATHIOPRINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AZATHIOPRINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | P |
AZATHIOPRINE SODIUM 100 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover AZATHIOPRINE SODIUM 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | P |
AZELASTINE 0.15% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NH cover AZELASTINE 0.15% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:30 /25Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NH cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:30 /25Days |
AZELASTINE HCL 0.05% DROPS ![Compare how all Medicare Part D PDP plans in NH cover AZELASTINE HCL 0.05% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AZITHROMYCIN 1 GM PWD PACKET ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN 1 GM PWD PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AZITHROMYCIN 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
AZITHROMYCIN 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AZITHROMYCIN 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | N/A | None |
AZITHROMYCIN I.V. 500 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover AZITHROMYCIN I.V. 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AZOPT 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NH cover AZOPT 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Aztreonam 1000 MG Injection [Azactam] ![Compare how all Medicare Part D PDP plans in NH cover Aztreonam 1000 MG Injection [Azactam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
Aztreonam 2000 MG Injection [Azactam] ![Compare how all Medicare Part D PDP plans in NH cover Aztreonam 2000 MG Injection [Azactam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
39% | N/A | None |