2018 Medicare Part D Plan Formulary Information |
WellCare Classic (PDP) (S4802-074-0)
Benefit Details
 |
The WellCare Classic (PDP) (S4802-074-0) Formulary Drugs Starting with the Letter N in CMS PDP Region 20 which includes: MS Plan Monthly Premium: $25.60 Deductible: $405 Qualifies for LIS: Yes |
Drugs Starting with Letter N
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
NABUMETONE 500 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NABUMETONE 750 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NADOLOL 20 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NADOLOL 40MG TABLETS  |
2 |
Generic |
$1.00 | $2.50 | None |
NADOLOL 80 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
Nafcillin 1 gm vial  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NAFCILLIN 10 GM BULK VIAL  |
5 |
Specialty Tier |
25% | N/A | None |
NAGLAZYME 5MG/5ML VIAL  |
5 |
Specialty Tier |
25% | N/A | P |
Nalbuphine Hydrochloride 10mg/mL 1 VIAL, MULTI-DOSE per CARTON / 10 mL in 1 VIAL, MULTI-DOSE  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Nalbuphine Hydrochloride 20mg/mL 25 VIAL, MULTI-DOSE per CARTON / 10 mL in 1 VIAL, MULTI-DOSE  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NALOXONE 0.4 MG/ML CARPUJECT  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NALOXONE 0.4 MG/ML VIAL  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
naloxone 1 mg/ml syringe  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NALTREXONE 50 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NAMENDA XR 14 MG CAPSULE  |
3 |
Preferred Brand |
$29.00 | $72.50 | P |
NAMENDA XR 21 MG CAPSULE  |
3 |
Preferred Brand |
$29.00 | $72.50 | P |
NAMENDA XR 28 MG CAPSULE  |
3 |
Preferred Brand |
$29.00 | $72.50 | P |
NAMENDA XR 7 MG CAPSULE  |
3 |
Preferred Brand |
$29.00 | $72.50 | P |
NAMENDA XR TITRATION PACK  |
3 |
Preferred Brand |
$29.00 | $72.50 | P |
NAMZARIC 14 MG-10 MG CAPSULE  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NAMZARIC 21 MG-10 MG CAPSULE  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NAMZARIC 28 MG-10 MG CAPSULE  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NAMZARIC 7 MG-10 MG CAPSULE  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NAMZARIC TITRATION PACK  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Naproxen 125 mg/5 ml suspen  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NAPROXEN 250 MG ORAL TABLET  |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
NAPROXEN 375 MG TABLET  |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
NAPROXEN 500 MG TABLET  |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
NAPROXEN DR 375 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NAPROXEN DR 500 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NARCAN 4 MG NASAL SPRAY  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NATACYN EYE DROPS  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NATEGLINIDE 120 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | Q:90 /30Days |
NATEGLINIDE 60 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | Q:90 /30Days |
NATPARA 100 MCG DOSE CARTRIDGE  |
5 |
Specialty Tier |
25% | N/A | P |
NATPARA 25 MCG DOSE CARTRIDGE  |
5 |
Specialty Tier |
25% | N/A | P |
NATPARA 50 MCG DOSE CARTRIDGE  |
5 |
Specialty Tier |
25% | N/A | P |
NATPARA 75 MCG DOSE CARTRIDGE  |
5 |
Specialty Tier |
25% | N/A | P |
NEBUPENT 300MG INHAL POWDER  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NECON 0.5-35-28 TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NECON 7-7-7-28 TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEFAZODONE HCL 150MG TABLET (60 CT)  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEFAZODONE HCL 250MG TABLET  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NEFAZODONE HCL 50MG TABLET  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEFAZODONE HYDROCHLORIDE TABLETS 100MG 60 BOT  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEFAZODONE HYDROCHLORIDE TABLETS 200MG 60 BOT  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEO/POLYMYXIN/HC EAR TUBEX 10MG/3.5MG/100UNT  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEOMYC-POLYM-DEXAMET EYE OINTM [Poly-Dex] ![Compare how all Medicare Part D PDP plans in MS cover NEOMYC-POLYM-DEXAMET EYE OINTM [Poly-Dex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $2.50 | None |
NEOMYC-POLYM-DEXAMETH EYE DROP  |
2 |
Generic |
$1.00 | $2.50 | None |
NEOMYCIN SULFATE 500MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEOMYCIN-BACITRACIN-POLY-HC 3.5-10K-1 OINTMENT  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEOMYCIN/POLYMY/HYDRO OTIC SUS  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEPHRAMINE SOLUTION FOR INJECTION  |
4 |
Non-Preferred Drug |
42% | 42% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NERLYNX 40 MG TABLET  |
5 |
Specialty Tier |
25% | N/A | P |
NEUPOGEN 300 MCG/ML VIAL  |
5 |
Specialty Tier |
25% | N/A | P |
NEUPOGEN 300MCG/ML VIAL  |
5 |
Specialty Tier |
25% | N/A | P |
NEUPOGEN 300ug/0.5mL 10 SYRINGE in 1 BOX / 0.5 mL in 1 SYRINGE  |
5 |
Specialty Tier |
25% | N/A | P |
NEUPOGEN INJECTION 480MCG/0.8ML 10 X 0.8ML SYR  |
5 |
Specialty Tier |
25% | N/A | P |
NEUPRO 1 MG/24 HR PATCH  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEUPRO 2 MG/24 HR PATCH  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEUPRO 3 MG/24 HR PATCH  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEUPRO 4 MG/24 HR PATCH  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEUPRO 6 MG/24 HR PATCH  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEUPRO 8 MG/24 HR PATCH  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NEVIRAPINE 200 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NEVIRAPINE ER 100 MG TABLET  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEVIRAPINE ER 400 MG TABLET  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NEXAVAR TABLETS 200MG 120 BOT  |
5 |
Specialty Tier |
25% | N/A | P |
NIACIN ER 1,000 MG TABLET [Niaspan ER] ![Compare how all Medicare Part D PDP plans in MS cover NIACIN ER 1,000 MG TABLET [Niaspan ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
42% | 42% | None |
NIACIN ER 500 MG TABLET [Niaspan ER] ![Compare how all Medicare Part D PDP plans in MS cover NIACIN ER 500 MG TABLET [Niaspan ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
42% | 42% | Q:90 /30Days |
NIACIN ER 750 MG TABLET [Niaspan ER] ![Compare how all Medicare Part D PDP plans in MS cover NIACIN ER 750 MG TABLET [Niaspan ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
42% | 42% | None |
NIACOR 500 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Nicardipine hydrochloride 20 MG Oral Capsule  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Nicardipine hydrochloride 30 MG Oral Capsule  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NICOTROL INHALER 10MG 168 X 10MG/CARTRIDGE INHL  |
4 |
Non-Preferred Drug |
42% | 42% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NICOTROL NS NASAL SPRAY BOTTLE 10MG 4 X 10MG/ML INHL  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NIFEDIPINE ER 30 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NIFEDIPINE ER 30 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NIFEDIPINE ER 60 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NIFEDIPINE ER 60 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NIFEDIPINE ER 90 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NIFEDIPINE ER 90 MG TABLET  |
2 |
Generic |
$1.00 | $2.50 | None |
NIKKI 3 MG-0.02 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NILUTAMIDE 150 MG TABLET [Nilandron] ![Compare how all Medicare Part D PDP plans in MS cover NILUTAMIDE 150 MG TABLET [Nilandron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
NIMODIPINE 30 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | None |
NINLARO 2.3 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NINLARO 3 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | P |
NINLARO 4 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | P |
NIPENT FOR INJECTION 10MG VIALS  |
5 |
Specialty Tier |
25% | N/A | P |
NITRO-BID 2% OINTMENT  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NITROFURANTOIN MACROCRYSTALLINE 50 mg cap  |
4 |
Non-Preferred Drug |
42% | 42% | P |
Nitrofurantoin mcr 100 mg cap  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NITROFURANTOIN MONO-MCR 100 MG  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NITROGLYCERIN 0.2 MG/HR PATCH  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NITROGLYCERIN 0.3 MG TABLET SL  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NITROGLYCERIN 0.4 MG TABLET SL  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NITROGLYCERIN 0.4 MG/HR PATCH  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NITROGLYCERIN 0.6 MG TABLET SL  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NITROGLYCERIN 0.6 MG/HR PATCH  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NITROGLYCERIN TRANSOERMAL SYSTEM .1MG/HR 30 SYSTEM BOX  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORA-BE 0.35MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Norditropin 10mg/1.5mL 1 SYRINGE, PLASTIC per CARTON / 1.5 mL in 1 SYRINGE, PLASTIC  |
5 |
Specialty Tier |
25% | N/A | P |
Norditropin 15mg/1.5mL 1 SYRINGE, PLASTIC per CARTON / 1.5 mL in 1 SYRINGE, PLASTIC  |
5 |
Specialty Tier |
25% | N/A | P |
Norditropin 5mg/1.5mL 1 SYRINGE, PLASTIC per CARTON / 1.5 mL in 1 SYRINGE, PLASTIC  |
5 |
Specialty Tier |
25% | N/A | P |
NORDITROPIN FLEXPRO 30 MG/3 ML  |
5 |
Specialty Tier |
25% | N/A | P |
NORETHIN-ETH ESTRAD 1 MG-5 MCG  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NORETHIND-ETH ESTRAD 1-0.02 MG  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORETHINDRONE 0.35 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NORETHINDRONE 5MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORG-EE 0.18-0.215-0.25/0.035  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORG-ETHIN ESTRA 0.18-0.215-0.25/0.025  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORG-ETHIN ESTRA 0.25-0.035 MG  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Norlyroc 0.35 mg tablet  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORMOSOL -R INJ /D5W  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NORMOSOL-M AND DEXTROSE 5%  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NORMOSOL-R PH 7.4 IV SOLUTION  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NORPACE CR 100 MG CAPSULE  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NORPACE CR 150MG CAPSULE SA  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NORTHERA 100 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NORTHERA 200 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | P |
NORTHERA 300 MG CAPSULE  |
5 |
Specialty Tier |
25% | N/A | P |
Nortrel (21 Day Regimen) 0.035; 1mg/1; mg/1 3 BLISTER PACK per CARTON / 21 TABLET per BLISTER PACK  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Nortrel (28 Day Regimen) 3 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORTREL 1-0.035MG TABLET 28DAY  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Nortrel 7/7/7 (28 Day Regimen) 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORTRIPTYLINE 10 MG/5 ML SOL  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NORTRIPTYLINE HCL 25MG CAP  |
2 |
Generic |
$1.00 | $2.50 | None |
NORTRIPTYLINE HCL 50 MG CAP  |
2 |
Generic |
$1.00 | $2.50 | None |
NORTRIPTYLINE HCL 75 MG CAP  |
2 |
Generic |
$1.00 | $2.50 | None |
Nortriptyline Hydrochloride 10mg/1 100 CAPSULE BOTTLE  |
2 |
Generic |
$1.00 | $2.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NORVIR 100 MG POWDER PACKET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORVIR 100 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORVIR 100mg/1 30 CAPSULE BOTTLE  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NORVIR 80MG/ML ORAL SOLUTION  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Novolin 100[iU]/mL 1 VIAL per CARTON / 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover Novolin 100[iU]/mL 1 VIAL per CARTON / 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Novolin 100[USP'U]/mL 1 VIAL per CARTON / 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover Novolin 100[USP'U]/mL 1 VIAL per CARTON / 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Novolin R 100[iU]/mL 1 VIAL per CARTON / 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in MS cover Novolin R 100[iU]/mL 1 VIAL per CARTON / 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NOVOLOG 100 UNIT/ML CARTRIDGE  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NOVOLOG 100U/ML VIAL  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NOVOLOG FLEXPEN SYRINGE  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NOVOLOG MIX 70/30 SYRINGE 70-30U/ML  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NOVOLOG MIX 70/30 VIAL  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NOXAFIL 200MG/5ML SUSPENSION ORAL  |
5 |
Specialty Tier |
25% | N/A | Q:630 /30Days |
NOXAFIL DR 100 MG TABLET  |
5 |
Specialty Tier |
25% | N/A | Q:93 /30Days |
NUCYNTA ER 100 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | Q:120 /30Days |
NUCYNTA ER 150 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | Q:60 /30Days |
NUCYNTA ER 200 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | Q:60 /30Days |
NUCYNTA ER 250 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | Q:60 /30Days |
NUCYNTA ER 50 MG TABLET  |
3 |
Preferred Brand |
$29.00 | $72.50 | Q:120 /30Days |
NUEDEXTA 20; 10mg/1; mg/1  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NULOJIX 250mg/1 1 VIAL, SINGLE-USE per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in  |
5 |
Specialty Tier |
25% | N/A | P |
NULYTELY WITH FLAVOR PACKS POWDER FOR SOLUTION 420;1.48;MG;MG;GM; 4 L BOT  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
NUPLAZID 17 MG TABLET  |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
NUTRILIPID 20 % EMULSION  |
4 |
Non-Preferred Drug |
42% | 42% | P |
NUVARING 0.12-0.015 RING VAGINAL  |
4 |
Non-Preferred Drug |
42% | 42% | None |
NYAMYC 100,000 UNITS/GM POWDER  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NYMALIZE 30 MG/10 ML SOLUTION  |
5 |
Specialty Tier |
25% | N/A | None |
NYSTATIN 100,000 UNIT/GM CREAM  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NYSTATIN 100,000 UNIT/GM POWD  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NYSTATIN 100,000 UNITS/GM OINT  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
Nystatin 100000[USP'U]/mL ![Compare how all Medicare Part D PDP plans in MS cover Nystatin 100000[USP'U]/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NYSTATIN 500,000 UNIT ORAL TAB  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |
NYSTOP 100,000 UNITS/GM POWDER  |
3 |
Preferred Brand |
$29.00 | $72.50 | None |