2018 Medicare Part D Plan Formulary Information |
Humana Preferred Rx Plan (PDP) (S5884-145-0)
Benefit Details
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The Humana Preferred Rx Plan (PDP) (S5884-145-0) Formulary Drugs Starting with the Letter S in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY Plan Monthly Premium: $31.90 Deductible: $405 Qualifies for LIS: Yes |
Drugs Starting with Letter S
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN ![Compare how all Medicare Part D PDP plans in MN cover SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:4 /30Days |
SANDIMMUNE 100MG/ML TUBEX ![Compare how all Medicare Part D PDP plans in MN cover SANDIMMUNE 100MG/ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | P |
SANTYL OINTMENT ![Compare how all Medicare Part D PDP plans in MN cover SANTYL OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SAPHRIS 10 MG TAB SL BLK CHERY ![Compare how all Medicare Part D PDP plans in MN cover SAPHRIS 10 MG TAB SL BLK CHERY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SAPHRIS 2.5 MG TAB SL BLK CHRY ![Compare how all Medicare Part D PDP plans in MN cover SAPHRIS 2.5 MG TAB SL BLK CHRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SAPHRIS 5 MG TAB SL BLK CHERRY ![Compare how all Medicare Part D PDP plans in MN cover SAPHRIS 5 MG TAB SL BLK CHERRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SAVELLA TABLETS 100MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MN cover SAVELLA TABLETS 100MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SAVELLA TABLETS 12.5MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MN cover SAVELLA TABLETS 12.5MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SAVELLA TABLETS 25MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MN cover SAVELLA TABLETS 25MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM ![Compare how all Medicare Part D PDP plans in MN cover SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SAVELLA TALBETS 50MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MN cover SAVELLA TALBETS 50MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SCOPOLAMINE 1 MG/3 DAY PATCH [Transderm Scop] ![Compare how all Medicare Part D PDP plans in MN cover SCOPOLAMINE 1 MG/3 DAY PATCH [Transderm Scop].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:10 /30Days |
SELEGILINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SELEGILINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SELEGILINE HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SELEGILINE HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:240 /30Days |
SELZENTRY 20 MG/ML ORAL SOLN ![Compare how all Medicare Part D PDP plans in MN cover SELZENTRY 20 MG/ML ORAL SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:920 /30Days |
SELZENTRY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SELZENTRY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:240 /30Days |
SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:120 /30Days |
SELZENTRY 75 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SELZENTRY 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:120 /30Days |
SENSIPAR 30MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SENSIPAR 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SENSIPAR 60MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SENSIPAR 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SENSIPAR 90MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SENSIPAR 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:120 /30Days |
SEREVENT DIS AER 50MCG ![Compare how all Medicare Part D PDP plans in MN cover SEREVENT DIS AER 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MN cover Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MN cover Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SERTRALINE 20 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in MN cover SERTRALINE 20 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SERTRALINE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SERTRALINE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:60 /30Days |
SERTRALINE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SERTRALINE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:90 /30Days |
SERTRALINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SERTRALINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:90 /30Days |
SETLAKIN 0.15 MG-0.03 MG TAB ![Compare how all Medicare Part D PDP plans in MN cover SETLAKIN 0.15 MG-0.03 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:91 /90Days |
SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA] ![Compare how all Medicare Part D PDP plans in MN cover SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:540 /30Days |
SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA] ![Compare how all Medicare Part D PDP plans in MN cover SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SHAROBEL 0.35 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SHAROBEL 0.35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SHINGRIX VIAL KIT ![Compare how all Medicare Part D PDP plans in MN cover SHINGRIX VIAL KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:2 /365Days |
Signifor .3 mg/mL ![Compare how all Medicare Part D PDP plans in MN cover Signifor .3 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
Signifor .6 mg/mL ![Compare how all Medicare Part D PDP plans in MN cover Signifor .6 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
Signifor .9 mg/mL ![Compare how all Medicare Part D PDP plans in MN cover Signifor .9 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SILDENAFIL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SILDENAFIL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | P Q:90 /30Days |
SILVER SULFADIAZINE 1% CREAM ![Compare how all Medicare Part D PDP plans in MN cover SILVER SULFADIAZINE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
SIMPONI 100 MG/ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in MN cover SIMPONI 100 MG/ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /30Days |
SIMPONI 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MN cover SIMPONI 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:3 /30Days |
SIMULECT 20MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SIMULECT 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SIMVASTATIN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIMVASTATIN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIMVASTATIN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIMVASTATIN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 40 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIMVASTATIN 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIMVASTATIN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 80 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIMVASTATIN 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:30 /30Days |
Sirolimus 0.5 MG Tablet [Rapamune] ![Compare how all Medicare Part D PDP plans in MN cover Sirolimus 0.5 MG Tablet [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | P |
SIROLIMUS 1 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in MN cover SIROLIMUS 1 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | P |
SIROLIMUS 2 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in MN cover SIROLIMUS 2 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | P |
SIRTURO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIRTURO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:68 /28Days |
SIVEXTRO 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SIVEXTRO 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:6 /28Days |
SIVEXTRO 200 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SIVEXTRO 200 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:6 /28Days |
SODIUM CHLORIDE 0.45% TUBEX ![Compare how all Medicare Part D PDP plans in MN cover SODIUM CHLORIDE 0.45% TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SODIUM CHLORIDE 0.9% IV SOLN ![Compare how all Medicare Part D PDP plans in MN cover SODIUM CHLORIDE 0.9% IV SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SODIUM LACTATE 5 MEQ/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover SODIUM LACTATE 5 MEQ/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SODIUM PHENYLBUTYRATE POWDER [Buphenyl] ![Compare how all Medicare Part D PDP plans in MN cover SODIUM PHENYLBUTYRATE POWDER [Buphenyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
SODIUM POLYSTYRENE SULF POWDER ![Compare how all Medicare Part D PDP plans in MN cover SODIUM POLYSTYRENE SULF POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SOLIQUA 100 UNIT-33 MCG/ML PEN ![Compare how all Medicare Part D PDP plans in MN cover SOLIQUA 100 UNIT-33 MCG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | S Q:15 /24Days |
SOLTAMOX 20 MG/10 ML SOLN Solution ![Compare how all Medicare Part D PDP plans in MN cover SOLTAMOX 20 MG/10 ML SOLN Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
SOMATULINE DEPOT 120 MG/0.5 ML ![Compare how all Medicare Part D PDP plans in MN cover SOMATULINE DEPOT 120 MG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /28Days |
SOMATULINE DEPOT 60 MG/0.2 ML ![Compare how all Medicare Part D PDP plans in MN cover SOMATULINE DEPOT 60 MG/0.2 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SOMATULINE DEPOT 90 MG/0.3 ML ![Compare how all Medicare Part D PDP plans in MN cover SOMATULINE DEPOT 90 MG/0.3 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SOMAVERT 10 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SOMAVERT 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SOMAVERT 15 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SOMAVERT 15 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SOMAVERT 20 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SOMAVERT 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SOMAVERT 25 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SOMAVERT 25 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
SOMAVERT 30 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SOMAVERT 30 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MN cover SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MN cover SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MN cover SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MN cover SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SOTALOL 160 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in MN cover SOTALOL 160 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SOTALOL 240 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in MN cover SOTALOL 240 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SOTALOL 80 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in MN cover SOTALOL 80 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
SOTALOL AF 120 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SOTALOL AF 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPIRIVA 18 MCG CP-HANDIHALER ![Compare how all Medicare Part D PDP plans in MN cover SPIRIVA 18 MCG CP-HANDIHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:30 /30Days |
SPIRIVA RESPIMAT 1.25 MCG INH ![Compare how all Medicare Part D PDP plans in MN cover SPIRIVA RESPIMAT 1.25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:4 /28Days |
SPIRIVA RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in MN cover SPIRIVA RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:4 /28Days |
SPIRONOLACTONE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPIRONOLACTONE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SPIRONOLACTONE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPIRONOLACTONE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
SPIRONOLACTONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPIRONOLACTONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SPIRONOLACTONE-HCTZ 25-25 TAB ![Compare how all Medicare Part D PDP plans in MN cover SPIRONOLACTONE-HCTZ 25-25 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SPRINTEC 0.25-0.035 TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRINTEC 0.25-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SPRITAM 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRITAM 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | S Q:90 /30Days |
SPRITAM 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRITAM 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | S Q:360 /30Days |
SPRITAM 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRITAM 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | S Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPRITAM 750 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRITAM 750 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | S Q:120 /30Days |
SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
SPRYCEL 20MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRYCEL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:90 /30Days |
SPRYCEL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRYCEL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SPRYCEL 70MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SPRYCEL 70MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
SPS 15 GM/60 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MN cover SPS 15 GM/60 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SRONYX 0.10-0.02 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SRONYX 0.10-0.02 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SSD 1% CREAM ![Compare how all Medicare Part D PDP plans in MN cover SSD 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
STAVUDINE 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover STAVUDINE 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
STAVUDINE 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover STAVUDINE 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:120 /30Days |
STAVUDINE CAPSULES 30MG 60 BOT ![Compare how all Medicare Part D PDP plans in MN cover STAVUDINE CAPSULES 30MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
STAVUDINE CAPSULES 40MG 60 BOT ![Compare how all Medicare Part D PDP plans in MN cover STAVUDINE CAPSULES 40MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
Sterile Water 6mg/mL 1 INJECTION, SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MN cover Sterile Water 6mg/mL 1 INJECTION, SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Stimate 1.5mg/mL 1 BOTTLE, SPRAY per CARTON / 2.5 mL in 1 BOTTLE, SPRAY ![Compare how all Medicare Part D PDP plans in MN cover Stimate 1.5mg/mL 1 BOTTLE, SPRAY per CARTON / 2.5 mL in 1 BOTTLE, SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
STIOLTO RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in MN cover STIOLTO RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:4 /28Days |
STIVARGA 40 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover STIVARGA 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:84 /28Days |
STRENSIQ 40 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover STRENSIQ 40 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
STRENSIQ 80 MG/0.8 ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover STRENSIQ 80 MG/0.8 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:38 /28Days |
STRIBILD TABLET ![Compare how all Medicare Part D PDP plans in MN cover STRIBILD TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
STRIVERDI RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in MN cover STRIVERDI RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:4 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUCRAID 8500[iU]/mL ![Compare how all Medicare Part D PDP plans in MN cover SUCRAID 8500[iU]/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
SUCRALFATE 1GM TABLET ![Compare how all Medicare Part D PDP plans in MN cover SUCRALFATE 1GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SULF-PRED 10-0.23% EYE DROPS ![Compare how all Medicare Part D PDP plans in MN cover SULF-PRED 10-0.23% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SULFACETAMIDE 10% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in MN cover SULFACETAMIDE 10% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SULFACETAMIDE SOD 10% TOP SUSP ![Compare how all Medicare Part D PDP plans in MN cover SULFACETAMIDE SOD 10% TOP SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT ![Compare how all Medicare Part D PDP plans in MN cover SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Sulfadiazine 500mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover Sulfadiazine 500mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SULFAMETHOXAZOLE-TMP DS TABLET [Septra DS] ![Compare how all Medicare Part D PDP plans in MN cover SULFAMETHOXAZOLE-TMP DS TABLET [Septra DS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
SULFAMETHOXAZOLE-TMP INJ VIAL ![Compare how all Medicare Part D PDP plans in MN cover SULFAMETHOXAZOLE-TMP INJ VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SULFAMETHOXAZOLE-TMP SS TABLET [Septra] ![Compare how all Medicare Part D PDP plans in MN cover SULFAMETHOXAZOLE-TMP SS TABLET [Septra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
SULFAMETHOXAZOLE-TMP SUSP Oral Suspension [Sultrex Pediatric] ![Compare how all Medicare Part D PDP plans in MN cover SULFAMETHOXAZOLE-TMP SUSP Oral Suspension [Sultrex Pediatric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SULFASALAZINE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SULFASALAZINE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SULFASALAZINE DR 500 MG TAB ![Compare how all Medicare Part D PDP plans in MN cover SULFASALAZINE DR 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SULINDAC 150 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SULINDAC 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SULINDAC 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SULINDAC 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | None |
SUMATRIPTAN 4 MG/0.5 ML CART ![Compare how all Medicare Part D PDP plans in MN cover SUMATRIPTAN 4 MG/0.5 ML CART.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:6 /30Days |
Sumatriptan 4 mg/0.5 ml inject ![Compare how all Medicare Part D PDP plans in MN cover Sumatriptan 4 mg/0.5 ml inject.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:6 /30Days |
SUMATRIPTAN 6 MG/0.5 ML INJECT ![Compare how all Medicare Part D PDP plans in MN cover SUMATRIPTAN 6 MG/0.5 ML INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:6 /30Days |
SUMATRIPTAN 6 MG/0.5 ML INJECT ![Compare how all Medicare Part D PDP plans in MN cover SUMATRIPTAN 6 MG/0.5 ML INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:6 /30Days |
Sumatriptan 6 mg/0.5 ml vial ![Compare how all Medicare Part D PDP plans in MN cover Sumatriptan 6 mg/0.5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:6 /30Days |
SUMATRIPTAN SUCC 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SUMATRIPTAN SUCC 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:9 /30Days |
SUMATRIPTAN SUCC 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SUMATRIPTAN SUCC 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:9 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MN cover Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$1.00 | $0.00 | Q:9 /30Days |
SUPRAX 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SUPRAX 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
SUPREP BOWEL PREP KIT SOLN RECON ![Compare how all Medicare Part D PDP plans in MN cover SUPREP BOWEL PREP KIT SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SUSTIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SUSTIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:120 /30Days |
SUSTIVA 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SUSTIVA 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | Q:480 /30Days |
SUSTIVA 600MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SUSTIVA 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
SUTENT 12.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SUTENT 12.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
SUTENT 25mg/1 28 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover SUTENT 25mg/1 28 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
SUTENT 37.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SUTENT 37.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
SUTENT 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SUTENT 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
SYEDA 28 TABLET [Zarah] ![Compare how all Medicare Part D PDP plans in MN cover SYEDA 28 TABLET [Zarah].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 30% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYLATRON 200 MCG KIT ![Compare how all Medicare Part D PDP plans in MN cover SYLATRON 200 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
SYLATRON 300 MCG KIT ![Compare how all Medicare Part D PDP plans in MN cover SYLATRON 300 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
SYLATRON 600 MCG KIT ![Compare how all Medicare Part D PDP plans in MN cover SYLATRON 600 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
SYLVANT 100 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SYLVANT 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SYLVANT 400 MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SYLVANT 400 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in MN cover SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:10 /30Days |
SYMBICORT 80; 4.5ug/1; ug/1 1 POUCH in 1 CARTON / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER ![Compare how all Medicare Part D PDP plans in MN cover SYMBICORT 80; 4.5ug/1; ug/1 1 POUCH in 1 CARTON / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:10 /30Days |
SYMFI 600-300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYMFI 600-300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
SYMFI LO 400-300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYMFI LO 400-300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
SYMLINPEN 60 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in MN cover SYMLINPEN 60 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:11 /28Days |
SYNAGIS 100 MG/1 ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover SYNAGIS 100 MG/1 ML 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 |
SYNAGIS 50MG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover SYNAGIS 50MG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
SYNAREL 2MG/ML NASAL SPRAY ![Compare how all Medicare Part D PDP plans in MN cover SYNAREL 2MG/ML NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
SYNERCID 500MG VIAL ![Compare how all Medicare Part D PDP plans in MN cover SYNERCID 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
SYNJARDY 12.5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY 12.5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SYNJARDY 12.5-500 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY 12.5-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SYNJARDY 5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY 5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SYNJARDY XR 10-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY XR 10-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:30 /30Days |
SYNJARDY XR 12.5-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY XR 12.5-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SYNJARDY XR 25-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY XR 25-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:30 /30Days |
SYNJARDY XR 5-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in MN cover SYNJARDY XR 5-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | Q:60 /30Days |
SYNRIBO 3.5 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MN cover SYNRIBO 3.5 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYNTHROID 100 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 100 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 112 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 112 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 125 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 125 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
Synthroid 137ug/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MN cover Synthroid 137ug/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 150 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 150 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 175 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 175 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 200 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 200 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 25 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 25 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 300 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 300 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 50 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 50 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYNTHROID 75 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 75 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYNTHROID 88 MCG TABLET ![Compare how all Medicare Part D PDP plans in MN cover SYNTHROID 88 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 15% | None |
SYPRINE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MN cover SYPRINE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |