2018 Medicare Part D Plan Formulary Information |
Presbyterian MediCare PPO Plan 2 with Rx (PPO) (H3206-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Presbyterian MediCare PPO Plan 2 with Rx (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Presbyterian MediCare PPO Plan 2 with Rx (PPO) (H3206-001-0) Formulary Drugs Starting with the Letter A in Sierra County, NM: CMS MA Region 20 which includes: NM Plan Monthly Premium: $163.00 Deductible: $375 |
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 NM cover ABACAVIR 20 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in NM cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABACAVIR-LAMIVUDINE 600-300 MG ![Compare how all Medicare Part D PDP plans in NM cover ABACAVIR-LAMIVUDINE 600-300 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABELCET INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in NM cover ABELCET INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
ABILIFY MAINTENA ER 300 MG SYR ![Compare how all Medicare Part D PDP plans in NM cover ABILIFY MAINTENA ER 300 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S |
ABILIFY MAINTENA ER 300 MG VL ![Compare how all Medicare Part D PDP plans in NM cover ABILIFY MAINTENA ER 300 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S |
ABILIFY MAINTENA ER 400 MG SUSER VIAL ![Compare how all Medicare Part D PDP plans in NM cover ABILIFY MAINTENA ER 400 MG SUSER VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S |
ABILIFY MAINTENA ER 400 MG SYR ![Compare how all Medicare Part D PDP plans in NM cover ABILIFY MAINTENA ER 400 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in NM cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACARBOSE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACARBOSE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACARBOSE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACARBOSE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACARBOSE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACARBOSE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACEBUTOLOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover ACEBUTOLOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACEBUTOLOL 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover ACEBUTOLOL 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACETAMINOP-CODEINE 120-12 MG/5 ![Compare how all Medicare Part D PDP plans in NM cover ACETAMINOP-CODEINE 120-12 MG/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Acetaminophen 325 MG / Hydrocodone Bitartrate 5 MG Oral Tablet [Lorcet] ![Compare how all Medicare Part D PDP plans in NM cover Acetaminophen 325 MG / Hydrocodone Bitartrate 5 MG Oral Tablet [Lorcet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:6 /1Days |
ACETAMINOPHEN-COD #2 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACETAMINOPHEN-COD #2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:6 /1Days |
ACETAMINOPHEN-COD #3 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACETAMINOPHEN-COD #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:6 /1Days |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:6 /1Days |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | 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 NM cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in NM cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
Acetylcysteine 200 MG/ML Inhalant Solution ![Compare how all Medicare Part D PDP plans in NM cover Acetylcysteine 200 MG/ML Inhalant Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in NM cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in NM cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in NM cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACTEMRA 162 MG/0.9 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NM cover ACTEMRA 162 MG/0.9 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
ACTHIB VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in NM cover ACTHIB VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in NM cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACYCLOVIR 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover ACYCLOVIR 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ACYCLOVIR 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NM cover ACYCLOVIR 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACYCLOVIR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACYCLOVIR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Acyclovir 5% Ointment ![Compare how all Medicare Part D PDP plans in NM cover Acyclovir 5% Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in NM cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
ADACEL TDAP SYRINGE ![Compare how all Medicare Part D PDP plans in NM cover ADACEL TDAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in NM cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ADAGEN 250U/ML VIAL ![Compare how all Medicare Part D PDP plans in NM cover ADAGEN 250U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in NM cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADCIRCA TABLETS 20MG 60 BOTTLE ![Compare how all Medicare Part D PDP plans in NM cover ADCIRCA TABLETS 20MG 60 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:2 /1Days |
ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera] ![Compare how all Medicare Part D PDP plans in NM cover ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /1Days |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /1Days |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /1Days |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /1Days |
ADRUCIL 50mg/mL 10 VIAL in 1 TRAY / 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NM 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) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in NM cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in NM cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in NM cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in NM 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) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in NM cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in NM cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFEDITAB CR 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in NM cover AFEDITAB CR 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AFEDITAB CR 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in NM cover AFEDITAB CR 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in NM 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 |
25% | N/A | P |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in NM cover AFINITOR TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR TABLETS 2.5 MG ![Compare how all Medicare Part D PDP plans in NM cover AFINITOR TABLETS 2.5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in NM cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Ala-cort 2.5% cream ![Compare how all Medicare Part D PDP plans in NM cover Ala-cort 2.5% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALBENZA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALBENZA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL SUL 2.5 MG/3 ML SOLN ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SUL 2.5 MG/3 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
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 NM 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 |
$10.00 | $20.00 | P |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
ALBUTEROL SULFATE 2 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE 2 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE 4 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE 4 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in NM cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALCLOMETASONE DIPR 0.05% OINT ![Compare how all Medicare Part D PDP plans in NM cover ALCLOMETASONE DIPR 0.05% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALCLOMETASONE DIPRO 0.05% CRM ![Compare how all Medicare Part D PDP plans in NM cover ALCLOMETASONE DIPRO 0.05% CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALDACTAZIDE 50/50 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALDACTAZIDE 50/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
ALDURAZYME 2.9MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in NM cover ALDURAZYME 2.9MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ALECENSA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover ALECENSA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /1Days |
ALENDRONATE SODIUM 10 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover ALENDRONATE SODIUM 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALENDRONATE SODIUM 35 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover ALENDRONATE SODIUM 35 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ALENDRONATE SODIUM 40 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALENDRONATE SODIUM 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALENDRONATE SODIUM 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALENDRONATE SODIUM 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ALENDRONATE SODIUM 70 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover ALENDRONATE SODIUM 70 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ALFUZOSIN HCL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALFUZOSIN HCL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
ALIMTA 100 MG VIAL ![Compare how all Medicare Part D PDP plans in NM cover ALIMTA 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ALIMTA 500 MG VIAL ![Compare how all Medicare Part D PDP plans in NM cover ALIMTA 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
ALIQOPA 60 MG VIAL ![Compare how all Medicare Part D PDP plans in NM cover ALIQOPA 60 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ALLOPURINOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALLOPURINOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ALLOPURINOL 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALLOPURINOL 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ALMOTRIPTAN MALATE 12.5 MG TAB [Axert] ![Compare how all Medicare Part D PDP plans in NM cover ALMOTRIPTAN MALATE 12.5 MG TAB [Axert].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:18 /30Days |
ALMOTRIPTAN MALATE 6.25 MG TAB [Axert] ![Compare how all Medicare Part D PDP plans in NM cover ALMOTRIPTAN MALATE 6.25 MG TAB [Axert].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:18 /30Days |
ALOCRIL 2% EYE DROPS ![Compare how all Medicare Part D PDP plans in NM cover ALOCRIL 2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ALOGLIPTIN 12.5 MG TABLET [Nesina] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN 12.5 MG TABLET [Nesina].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN 25 MG TABLET [Nesina] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN 25 MG TABLET [Nesina].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN 6.25 MG TABLET [Nesina] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN 6.25 MG TABLET [Nesina].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN-METFORMIN 12.5-1000 [Kazano] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-METFORMIN 12.5-1000 [Kazano].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALOGLIPTIN-METFORMIN 12.5-500 [Kazano] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-METFORMIN 12.5-500 [Kazano].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:2 /1Days |
ALOGLIPTIN-PIOGLIT 12.5-15 MG [Oseni] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-PIOGLIT 12.5-15 MG [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN-PIOGLIT 12.5-30 MG [Oseni] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-PIOGLIT 12.5-30 MG [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN-PIOGLIT 12.5-45 MG [Oseni] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-PIOGLIT 12.5-45 MG [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN-PIOGLIT 25-15 MG TABLET [Oseni] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-PIOGLIT 25-15 MG TABLET [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN-PIOGLIT 25-30 MG TABLET [Oseni] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-PIOGLIT 25-30 MG TABLET [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOGLIPTIN-PIOGLIT 25-45 MG TABLET [Oseni] ![Compare how all Medicare Part D PDP plans in NM cover ALOGLIPTIN-PIOGLIT 25-45 MG TABLET [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:1 /1Days |
ALOMIDE 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NM cover ALOMIDE 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ALORA 0.025 MG PATCH ![Compare how all Medicare Part D PDP plans in NM cover ALORA 0.025 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
ALORA 0.05 MG PATCH ![Compare how all Medicare Part D PDP plans in NM cover ALORA 0.05 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
ALORA 0.075 MG PATCH ![Compare how all Medicare Part D PDP plans in NM cover ALORA 0.075 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALORA 0.1 MG PATCH ![Compare how all Medicare Part D PDP plans in NM cover ALORA 0.1 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
ALOSETRON HCL 0.5 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in NM cover ALOSETRON HCL 0.5 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:2 /1Days |
ALOSETRON HCL 1 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in NM cover ALOSETRON HCL 1 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:2 /1Days |
ALOXI 0.25 MG/5 ML ![Compare how all Medicare Part D PDP plans in NM cover ALOXI 0.25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in NM cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ALPRAZOLAM 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALPRAZOLAM 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:5 /1Days |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in NM cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ALTAVERA-28 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALTAVERA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALUNBRIG 180 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALUNBRIG 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
ALUNBRIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALUNBRIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /1Days |
ALUNBRIG 90 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALUNBRIG 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
ALUNBRIG 90 MG-180 MG TABLET PACK ![Compare how all Medicare Part D PDP plans in NM cover ALUNBRIG 90 MG-180 MG TABLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
ALYACEN 1-35-28 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ALYACEN 1-35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
Amabelz 0.5 MG/0.1 MG 28 TABLET/BLISTER PACK 3 PER CARTON ![Compare how all Medicare Part D PDP plans in NM cover Amabelz 0.5 MG/0.1 MG 28 TABLET/BLISTER PACK 3 PER CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
Amabelz 1 MG/0.5 MG 28 TABLET/BLISTER PACK 3 PER CARTON ![Compare how all Medicare Part D PDP plans in NM cover Amabelz 1 MG/0.5 MG 28 TABLET/BLISTER PACK 3 PER CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMANTADINE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover AMANTADINE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMANTADINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMANTADINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AMBISOME 50MG VIAL ![Compare how all Medicare Part D PDP plans in NM cover AMBISOME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMCINONIDE 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in NM cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMETHIA LO TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMETHIA LO TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AMIKACIN SULF 500 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in NM cover AMIKACIN SULF 500 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMILORIDE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMILORIDE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMILORIDE HCL-HCTZ 5-50 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMILORIDE HCL-HCTZ 5-50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Amino Acids 15% Solution ![Compare how all Medicare Part D PDP plans in NM cover Amino Acids 15% Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
Aminophylline 25 MG/ML 10 ML Injection ![Compare how all Medicare Part D PDP plans in NM cover Aminophylline 25 MG/ML 10 ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMINOSYN HBC INJECTION SULFITE FREE 7% ![Compare how all Medicare Part D PDP plans in NM cover AMINOSYN HBC INJECTION SULFITE FREE 7%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in NM cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in NM cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMIODARONE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMIODARONE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMIODARONE HCL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMIODARONE HCL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMIODARONE HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMIODARONE HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMIODARONE HCL 50 MG/ML in 3 ML Injection ![Compare how all Medicare Part D PDP plans in NM cover AMIODARONE HCL 50 MG/ML in 3 ML Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:2 /1Days |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in NM cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:2 /1Days |
AMITRIPTYLINE HCL 10 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMITRIPTYLINE HCL 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMITRIPTYLINE HCL 100 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMITRIPTYLINE HCL 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMITRIPTYLINE HCL 150 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMITRIPTYLINE HCL 150 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMITRIPTYLINE HCL 25 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMITRIPTYLINE HCL 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMITRIPTYLINE HCL 50 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMITRIPTYLINE HCL 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMITRIPTYLINE HCL 75 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMITRIPTYLINE HCL 75 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
AMLODIPINE BESYLATE 10 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE BESYLATE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE BESYLATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE BESYLATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE BESYLATE 5 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE BESYLATE 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 10-20 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE-BENAZEPRIL 10-20 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 10-40 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE-BENAZEPRIL 10-40 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 2.5-10 Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE-BENAZEPRIL 2.5-10 Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-10 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE-BENAZEPRIL 5-10 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-20 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE-BENAZEPRIL 5-20 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-40 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in NM cover AMLODIPINE-BENAZEPRIL 5-40 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in NM cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in NM cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NM cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in NM cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX-CLAV 200-28.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in NM cover AMOX-CLAV 200-28.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX-CLAV 250-62.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in NM cover AMOX-CLAV 250-62.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX-CLAV 400-57 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NM cover AMOX-CLAV 400-57 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX-CLAV 500-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NM cover AMOX-CLAV 500-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX-CLAV 600-42.9 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in NM cover AMOX-CLAV 600-42.9 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOX-CLAV 875-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in NM cover AMOX-CLAV 875-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 250 MG TAB CHEW ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 250 MG TAB CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 400 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 400 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMOXICILLIN 875 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMOXICILLIN 875 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
AMPHETAMINE SALTS 5 MG TAB ![Compare how all Medicare Part D PDP plans in NM cover AMPHETAMINE SALTS 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | Q:3 /1Days |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NM cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
AMPICILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in NM cover AMPICILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Ampicillin 1000 MG / Sulbactam 500 MG Injection ![Compare how all Medicare Part D PDP plans in NM cover Ampicillin 1000 MG / Sulbactam 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Ampicillin 1000 MG Injection ![Compare how all Medicare Part D PDP plans in NM cover Ampicillin 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Ampicillin 2000 MG / Sulbactam 1000 MG Injection ![Compare how all Medicare Part D PDP plans in NM cover Ampicillin 2000 MG / Sulbactam 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in NM cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMPICILLIN-SULBACTAM 15 GM VL ![Compare how all Medicare Part D PDP plans in NM cover AMPICILLIN-SULBACTAM 15 GM VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AMPYRA ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AMPYRA ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANADROL-50 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ANADROL-50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NM cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NM cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ANASTROZOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ANASTROZOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ANDRODERM 2 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in NM cover ANDRODERM 2 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P Q:1 /1Days |
ANDRODERM 4 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in NM cover ANDRODERM 4 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P Q:1 /1Days |
ANDROGEL 1.62% (1.25G) GEL PCKT ![Compare how all Medicare Part D PDP plans in NM cover ANDROGEL 1.62% (1.25G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P Q:75 /30Days |
ANDROGEL 1.62% (2.5G) GEL PCKT ![Compare how all Medicare Part D PDP plans in NM cover ANDROGEL 1.62% (2.5G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | 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 NM 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 |
$45.00 | $112.50 | P Q:150 /30Days |
Antineoplastic Agent Etoposide 20 mg / mL Intravenous Injection Multiple Dose Vial 5 mL ![Compare how all Medicare Part D PDP plans in NM 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) |
2 |
Generic |
$10.00 | $20.00 | None |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in NM cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Apraclonidine 5 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in NM cover Apraclonidine 5 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
APREPITANT 125 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in NM cover APREPITANT 125 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
APREPITANT 125-80-80 MG PACK [Emend] ![Compare how all Medicare Part D PDP plans in NM cover APREPITANT 125-80-80 MG PACK [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P Q:12 /30Days |
APREPITANT 40 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in NM cover APREPITANT 40 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in NM cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
APRISO CP24 ![Compare how all Medicare Part D PDP plans in NM cover APRISO CP24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:4 /1Days |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in NM cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in NM cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in NM cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in NM cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:1 /1Days |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:1 /1Days |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:1 /1Days |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:1 /1Days |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:1 /1Days |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | S Q:1 /1Days |
ARIPIPRAZOLE ODT 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE ODT 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARIPIPRAZOLE ODT 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in NM cover ARIPIPRAZOLE ODT 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S Q:2 /1Days |
ARISTADA ER 1064 MG/3.9 ML SYR ![Compare how all Medicare Part D PDP plans in NM cover ARISTADA ER 1064 MG/3.9 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA ER 441 MG/1.6 ML SYRN ![Compare how all Medicare Part D PDP plans in NM cover ARISTADA ER 441 MG/1.6 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA ER 662 MG/2.4 ML SYRN ![Compare how all Medicare Part D PDP plans in NM cover ARISTADA ER 662 MG/2.4 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA ER 882 MG/3.2 ML SYRN ![Compare how all Medicare Part D PDP plans in NM cover ARISTADA ER 882 MG/3.2 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Armodafinil 150 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in NM cover Armodafinil 150 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P Q:1 /1Days |
Armodafinil 200 MG Oral Tablet [NUVIGIL] ![Compare how all Medicare Part D PDP plans in NM cover Armodafinil 200 MG Oral Tablet [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P Q:1 /1Days |
Armodafinil 250 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in NM cover Armodafinil 250 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P Q:1 /1Days |
Armodafinil 50 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in NM cover Armodafinil 50 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | P Q:1 /1Days |
ASMANEX HFA 100 MCG INHALER ![Compare how all Medicare Part D PDP plans in NM cover ASMANEX HFA 100 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ASMANEX HFA 200 MCG INHALER ![Compare how all Medicare Part D PDP plans in NM cover ASMANEX HFA 200 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASMANEX TWISTHALER 110 MCG #30 ![Compare how all Medicare Part D PDP plans in NM cover ASMANEX TWISTHALER 110 MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ASMANEX TWISTHALER 220 MCG #30 ![Compare how all Medicare Part D PDP plans in NM cover ASMANEX TWISTHALER 220 MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ASMANEX TWISTHALER 220MCG #120 ![Compare how all Medicare Part D PDP plans in NM cover ASMANEX TWISTHALER 220MCG #120.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
ASMANEX TWISTHALER 220MCG #60 ![Compare how all Medicare Part D PDP plans in NM cover ASMANEX TWISTHALER 220MCG #60.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
Aspirin-Diphenhydramine ER 25-200 MG ![Compare how all Medicare Part D PDP plans in NM cover Aspirin-Diphenhydramine ER 25-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
ATAZANAVIR SULFATE 150 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in NM cover ATAZANAVIR SULFATE 150 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ATAZANAVIR SULFATE 200 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in NM cover ATAZANAVIR SULFATE 200 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ATAZANAVIR SULFATE 300 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in NM cover ATAZANAVIR SULFATE 300 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ATENOLOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ATENOLOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ATENOLOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ATENOLOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
ATENOLOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover ATENOLOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in NM cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in NM cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ATOMOXETINE HCL 10 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 10 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATOMOXETINE HCL 100 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 100 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATOMOXETINE HCL 18 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 18 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATOMOXETINE HCL 25 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 25 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATOMOXETINE HCL 40 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 40 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATOMOXETINE HCL 60 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 60 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATOMOXETINE HCL 80 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in NM cover ATOMOXETINE HCL 80 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:1 /1Days |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NM cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NM cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NM cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in NM cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in NM cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in NM cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | 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 NM 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 |
25% | N/A | None |
ATROPINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NM cover ATROPINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in NM cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AUBAGIO 14 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AUBAGIO 14 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
AUBAGIO 7 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AUBAGIO 7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
AUBRA-28 TABLET ![Compare how all Medicare Part D PDP plans in NM cover AUBRA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AUSTEDO 12 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AUSTEDO 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AUSTEDO 6 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AUSTEDO 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
AUSTEDO 9 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AUSTEDO 9 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /1Days |
AVANDIA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AVANDIA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
AVANDIA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AVANDIA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
AVASTIN 100MG/4ML VIAL ![Compare how all Medicare Part D PDP plans in NM cover AVASTIN 100MG/4ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AVASTIN 400 MG/16 ML VIAL ![Compare how all Medicare Part D PDP plans in NM cover AVASTIN 400 MG/16 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in NM cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AVITA 0.025% CREAM ![Compare how all Medicare Part D PDP plans in NM cover AVITA 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
AVONEX ADMIN PACK 30 MCG VL ![Compare how all Medicare Part D PDP plans in NM cover AVONEX ADMIN PACK 30 MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
AVONEX PEN 30 MCG/0.5 ML KIT ![Compare how all Medicare Part D PDP plans in NM cover AVONEX PEN 30 MCG/0.5 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
AVONEX PREFILLED SYR 30 MCG KT ![Compare how all Medicare Part D PDP plans in NM cover AVONEX PREFILLED SYR 30 MCG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVYCAZ 2.5 GRAM VIAL ![Compare how all Medicare Part D PDP plans in NM cover AVYCAZ 2.5 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Azacitidine 100 mg vial [Vidaza] ![Compare how all Medicare Part D PDP plans in NM cover Azacitidine 100 mg vial [Vidaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
AZASITE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NM cover AZASITE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |
AZATHIOPRINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AZATHIOPRINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | P |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NM cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AZELASTINE HCL 0.05% DROPS ![Compare how all Medicare Part D PDP plans in NM cover AZELASTINE HCL 0.05% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AZELEX 20% CREAM 30GM TUBE ![Compare how all Medicare Part D PDP plans in NM cover AZELEX 20% CREAM 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AZITHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AZITHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NM cover Azithromycin 500mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZITHROMYCIN 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NM cover AZITHROMYCIN 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AZITHROMYCIN I.V. 500 MG VIAL ![Compare how all Medicare Part D PDP plans in NM cover AZITHROMYCIN I.V. 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $20.00 | None |
AZOPT 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NM cover AZOPT 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $112.50 | None |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in NM cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None |