2019 Medicare Part D Plan Formulary Information |
Medica Prime Solution Total w/Rx (Cost) (H2450-041-0)
Benefit Details
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The Medica Prime Solution Total w/Rx (Cost) (H2450-041-0) Formulary Drugs Starting with the Letter V in Sawyer County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $216.00 Deductible: $260 |
Drugs Starting with Letter V
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
VALACYCLOVIR HCL 1 GRAM TABLET ![Compare how all Medicare Part D PDP plans in WI cover VALACYCLOVIR HCL 1 GRAM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VALACYCLOVIR HCL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VALACYCLOVIR HCL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VALCHLOR 0.016% GEL ![Compare how all Medicare Part D PDP plans in WI cover VALCHLOR 0.016% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VALGANCICLOVIR 450 MG TABLET [Valcyte] ![Compare how all Medicare Part D PDP plans in WI cover VALGANCICLOVIR 450 MG TABLET [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VALGANCICLOVIR HCL 50 MG/ML [Valcyte] ![Compare how all Medicare Part D PDP plans in WI cover VALGANCICLOVIR HCL 50 MG/ML [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VALPROIC ACID 250 MG CAPSULE [Depakene] ![Compare how all Medicare Part D PDP plans in WI cover VALPROIC ACID 250 MG CAPSULE [Depakene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VALPROIC ACID 250 MG/5 ML SOLN Solution [Depakene] ![Compare how all Medicare Part D PDP plans in WI cover VALPROIC ACID 250 MG/5 ML SOLN Solution [Depakene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VALSARTAN 160 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 160 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN 320 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 320 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN 40 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 40 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VALSARTAN 80 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 80 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 160-12.5 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN-HCTZ 160-25 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 160-25 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN-HCTZ 320-12.5 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 320-12.5 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN-HCTZ 320-25 MG TAB [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 320-25 MG TAB [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VALSARTAN-HCTZ 80-12.5 MG Tablet [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 80-12.5 MG Tablet [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VANCOMYCIN 500 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VANCOMYCIN HCL 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VANCOMYCIN HCL 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VANCOMYCIN HCL 750 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 750 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE ) ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL INJECTION 10 X 1GM VIAL (STERILE ).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VANDAZOLE 0.75% GEL WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in WI cover VANDAZOLE 0.75% GEL WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VAQTA 25 UNITS/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover VAQTA 25 UNITS/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VAQTA 50 UNITS/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover VAQTA 50 UNITS/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
Vaqta Hepatitis A Vaccine Adult 50 Unit / mL Injection Single Dose Vial 1 mL ![Compare how all Medicare Part D PDP plans in WI cover Vaqta Hepatitis A Vaccine Adult 50 Unit / mL Injection Single Dose Vial 1 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL ![Compare how all Medicare Part D PDP plans in WI cover Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VARIVAX VACCINE W/DILUENT ![Compare how all Medicare Part D PDP plans in WI cover VARIVAX VACCINE W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VASCEPA 0.5 GM CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VASCEPA 0.5 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VASCEPA 1 GM CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VASCEPA 1 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VELIVET 28 DAY TABLET [Velivet] ![Compare how all Medicare Part D PDP plans in WI cover VELIVET 28 DAY TABLET [Velivet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VEMLIDY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VEMLIDY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VENCLEXTA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | P |
VENCLEXTA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VENCLEXTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | P |
VENCLEXTA STARTING PACK ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA STARTING PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VENLAFAXINE HCL 100 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 100 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VENLAFAXINE HCL 25 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 25 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VENLAFAXINE HCL 37.5 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 37.5 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VENLAFAXINE HCL 50 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 50 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VENLAFAXINE HCL 75 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 75 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VENLAFAXINE HCL ER 150 MG CAPSULE 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 150 MG CAPSULE 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
VENLAFAXINE HCL ER 37.5 MG CAPSULE 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 37.5 MG CAPSULE 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VENLAFAXINE HCL ER 75 MG CAPSULE 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 75 MG CAPSULE 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
Ventavis 0.01mg/mL ![Compare how all Medicare Part D PDP plans in WI cover Ventavis 0.01mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
Ventavis 0.02mg/mL ![Compare how all Medicare Part D PDP plans in WI cover Ventavis 0.02mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VENTOLIN HFA 90MCG INHALER ![Compare how all Medicare Part D PDP plans in WI cover VENTOLIN HFA 90MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | Q:36 /30Days |
VERAPAMIL 120 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VERAPAMIL 120MG CAP PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 120MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VERAPAMIL 180MG CAP PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 180MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VERAPAMIL 240MG CAP PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 240MG CAP PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VERAPAMIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VERAPAMIL 80 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 100MG CAPSULE 24HR SR PELLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VERAPAMIL ER 120 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
VERAPAMIL ER 180 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 200MG CAPSULE 24HR SR PELLETS (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VERAPAMIL ER 240 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 240 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
VERAPAMIL ER PM 300 MG CAPSULE 24H PCT [Verelan PM] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER PM 300 MG CAPSULE 24H PCT [Verelan PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VERSACLOZ 50 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover VERSACLOZ 50 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:600 /30Days |
VERZENIO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VERZENIO 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VERZENIO 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VERZENIO 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VICTOZA 3-PAK 18 MG/3 ML PEN ![Compare how all Medicare Part D PDP plans in WI cover VICTOZA 3-PAK 18 MG/3 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | Q:9 /30Days |
VIDEX 4 GM PEDIATRIC SOLN ![Compare how all Medicare Part D PDP plans in WI cover VIDEX 4 GM PEDIATRIC SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VIDEX EC 125MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover VIDEX EC 125MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VIENVA-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIENVA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
VIGABATRIN 500 MG POWDER PACKET [SABRIL] ![Compare how all Medicare Part D PDP plans in WI cover VIGABATRIN 500 MG POWDER PACKET [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:180 /30Days |
VIGABATRIN 500 MG TABLET [Sabril] ![Compare how all Medicare Part D PDP plans in WI cover VIGABATRIN 500 MG TABLET [Sabril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:180 /30Days |
VIGADRONE 500 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover VIGADRONE 500 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:180 /30Days |
VIIBRYD 10-20 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 10-20 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIMPAT 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover VIMPAT 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | Q:1200 /30Days |
Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | Q:60 /30Days |
Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | Q:60 /30Days |
Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | Q:60 /30Days |
Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:120 /30Days |
VIRACEPT 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIRACEPT 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VIRACEPT 625MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIRACEPT 625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VIRAMUNE 50MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover VIRAMUNE 50MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VIREAD 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VIREAD 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VIREAD 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIREAD POWDER ![Compare how all Medicare Part D PDP plans in WI cover VIREAD POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VITRAKVI 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VITRAKVI 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VITRAKVI 20 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover VITRAKVI 20 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VITRAKVI 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VITRAKVI 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VIVITROL INJECTABLE SUSPENSION 380MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover VIVITROL INJECTABLE SUSPENSION 380MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VIZIMPRO 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIZIMPRO 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VIZIMPRO 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIZIMPRO 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VIZIMPRO 45 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIZIMPRO 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VORICONAZOLE 200 MG TABLET [VFEND] ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 200 MG TABLET [VFEND].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VORICONAZOLE 200 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 200 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
Voriconazole 40 MG/ML Oral Suspension ![Compare how all Medicare Part D PDP plans in WI cover Voriconazole 40 MG/ML Oral Suspension.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VORICONAZOLE 50 MG TABLET [VFEND] ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 50 MG TABLET [VFEND].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | None |
VOSEVI 400-100-100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VOSEVI 400-100-100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VOTRIENT 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VOTRIENT 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P |
VRAYLAR 1.5 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 1.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:60 /30Days |
VRAYLAR 1.5 MG-3 MG PACK ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 1.5 MG-3 MG PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | P |
VRAYLAR 3 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 3 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:30 /30Days |
VRAYLAR 4.5 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 4.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:30 /30Days |
VRAYLAR 6 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 6 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 28% | P Q:30 /30Days |
Vyfemla 28 tablet ![Compare how all Medicare Part D PDP plans in WI cover Vyfemla 28 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$28.00 | $56.00 | None |
VYLIBRA 28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYLIBRA 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $16.00 | None |
VYTORIN 10-10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VYTORIN 10-20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VYTORIN 10-40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VYTORIN 10-80 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
VYVANSE 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
VYVANSE 10 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 10 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
VYVANSE 20 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 20 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
VYVANSE 30 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 30 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
VYVANSE 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
VYVANSE 40 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 40 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VYVANSE 40MG CAPSULE 100 EA ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 40MG CAPSULE 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VYVANSE 50 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 50 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VYVANSE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VYVANSE 60 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 60 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VYVANSE 70MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 70MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |
VYVANSE CAPSULES 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE CAPSULES 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
VYVANSE CAPSULES 60MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE CAPSULES 60MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:30 /30Days |