2019 Medicare Part D Plan Formulary Information |
Banner - University Care Advantage (HMO SNP) (H4931-007-0)
Benefit Details
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The Banner - University Care Advantage (HMO SNP) (H4931-007-0) Formulary Drugs Starting with the Letter I in Pinal County, AZ: CMS MA Region 21 which includes: AZ Plan Monthly Premium: $32.60 Deductible: $415 |
Drugs Starting with Letter I
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
IBANDRONATE SODIUM 150 MG TABLET [Boniva] ![Compare how all Medicare Part D PDP plans in AZ cover IBANDRONATE SODIUM 150 MG TABLET [Boniva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:1 /28Days |
IBRANCE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover IBRANCE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:21 /28Days |
IBRANCE 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover IBRANCE 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:21 /28Days |
IBRANCE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover IBRANCE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:21 /28Days |
Ibuprofen 100mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in AZ cover Ibuprofen 100mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IBUPROFEN 400 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IBUPROFEN 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IBUPROFEN 600 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IBUPROFEN 600 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IBUPROFEN 600mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in AZ cover IBUPROFEN 600mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IBUPROFEN 800 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IBUPROFEN 800 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IBUPROFEN 800 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IBUPROFEN 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ICLUSIG 15 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ICLUSIG 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:60 /30Days |
ICLUSIG 45 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ICLUSIG 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:30 /30Days |
IDHIFA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IDHIFA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:30 /30Days |
IDHIFA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IDHIFA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:30 /30Days |
ILEVRO 0.3% OPHTH DROPS ![Compare how all Medicare Part D PDP plans in AZ cover ILEVRO 0.3% OPHTH DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ILUMYA 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in AZ cover ILUMYA 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
IMATINIB MESYLATE 100 MG TAB [Gleevec] ![Compare how all Medicare Part D PDP plans in AZ cover IMATINIB MESYLATE 100 MG TAB [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:90 /30Days |
IMATINIB MESYLATE 400 MG TAB [Gleevec] ![Compare how all Medicare Part D PDP plans in AZ cover IMATINIB MESYLATE 400 MG TAB [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:60 /30Days |
IMBRUVICA 140 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover IMBRUVICA 140 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:120 /30Days |
IMBRUVICA 140 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IMBRUVICA 140 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:28 /28Days |
IMBRUVICA 280 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IMBRUVICA 280 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMBRUVICA 420 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IMBRUVICA 420 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:28 /28Days |
IMBRUVICA 560 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IMBRUVICA 560 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:28 /28Days |
IMBRUVICA 70 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover IMBRUVICA 70 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:28 /28Days |
IMIPRAMINE HCL 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AZ cover IMIPRAMINE HCL 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
IMIPRAMINE HCL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in AZ cover IMIPRAMINE HCL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
IMIPRAMINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IMIPRAMINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
IMIQUIMOD 5% CREAM PACKET ![Compare how all Medicare Part D PDP plans in AZ cover IMIQUIMOD 5% CREAM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:24 /30Days |
IMOVAX RABIES VACCINE ![Compare how all Medicare Part D PDP plans in AZ cover IMOVAX RABIES VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INBRIJA 42 MG INHALATION CAP CAP W/DEV ![Compare how all Medicare Part D PDP plans in AZ cover INBRIJA 42 MG INHALATION CAP CAP W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:300 /30Days |
INCASSIA 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in AZ cover INCASSIA 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in AZ cover Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INCRUSE ELLIPTA 62.5 MCG INH ![Compare how all Medicare Part D PDP plans in AZ cover INCRUSE ELLIPTA 62.5 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Indapamide 1.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in AZ cover Indapamide 1.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
INDAPAMIDE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INDAPAMIDE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
INDOMETHACIN 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover INDOMETHACIN 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:240 /30Days |
INDOMETHACIN 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover INDOMETHACIN 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:120 /30Days |
INFANRIX DTAP VIAL ![Compare how all Medicare Part D PDP plans in AZ cover INFANRIX DTAP VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
INGREZZA 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover INGREZZA 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:30 /30Days |
INGREZZA 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in AZ cover INGREZZA 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:30 /30Days |
INGREZZA INITIATION PACK CAPSULE DS PK ![Compare how all Medicare Part D PDP plans in AZ cover INGREZZA INITIATION PACK CAPSULE DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INLYTA 1 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INLYTA 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:180 /30Days |
INLYTA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INLYTA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INTELENCE 100MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INTELENCE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Intelence 200mg/1 ![Compare how all Medicare Part D PDP plans in AZ cover Intelence 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
INTELENCE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INTELENCE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
INTRALIPID 20% IV FAT EMUL EMULSION ![Compare how all Medicare Part D PDP plans in AZ cover INTRALIPID 20% IV FAT EMUL EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTRALIPID 30% IV FAT EMUL ![Compare how all Medicare Part D PDP plans in AZ cover INTRALIPID 30% IV FAT EMUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTRON A 10 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in AZ cover INTRON A 10 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTRON A 18 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in AZ cover INTRON A 18 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTRON A 25 MILLION UNIT/2.5ML VIAL ![Compare how all Medicare Part D PDP plans in AZ cover INTRON A 25 MILLION UNIT/2.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTRON A 50 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in AZ cover INTRON A 50 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTRON A 6MMU/ML VIAL ![Compare how all Medicare Part D PDP plans in AZ cover INTRON A 6MMU/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in AZ cover INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:91 /84Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Invega Sustenna 117 mg/0.75mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in AZ cover Invega Sustenna 117 mg/0.75mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:1 /28Days |
Invega Sustenna 156 mg/mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in AZ cover Invega Sustenna 156 mg/mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:1 /28Days |
Invega Sustenna 234 mg/1.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in AZ cover Invega Sustenna 234 mg/1.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:2 /28Days |
Invega Sustenna 39 mg/0.25mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in AZ cover Invega Sustenna 39 mg/0.25mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Invega Sustenna 78 mg/0.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in AZ cover Invega Sustenna 78 mg/0.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:1 /28Days |
INVEGA TRINZA 273 MG/0.875 ML ![Compare how all Medicare Part D PDP plans in AZ cover INVEGA TRINZA 273 MG/0.875 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:1 /84Days |
INVEGA TRINZA 410 MG/1.315 ML ![Compare how all Medicare Part D PDP plans in AZ cover INVEGA TRINZA 410 MG/1.315 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:1 /84Days |
INVEGA TRINZA 546 MG/1.75 ML ![Compare how all Medicare Part D PDP plans in AZ cover INVEGA TRINZA 546 MG/1.75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:2 /84Days |
INVEGA TRINZA 819 MG/2.625 ML ![Compare how all Medicare Part D PDP plans in AZ cover INVEGA TRINZA 819 MG/2.625 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:3 /84Days |
INVELTYS 1% EYE DROP Eye Dropper ![Compare how all Medicare Part D PDP plans in AZ cover INVELTYS 1% EYE DROP Eye Dropper.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
INVIRASE 500MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVIRASE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVOKAMET 150-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET 150-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKAMET 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKAMET 50-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET 50-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKAMET 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:120 /30Days |
INVOKAMET XR 150-1,000 MG TAB ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET XR 150-1,000 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKAMET XR 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET XR 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKAMET XR 50-1,000 MG TAB ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET XR 50-1,000 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKAMET XR 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKAMET XR 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKANA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKANA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:60 /30Days |
INVOKANA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover INVOKANA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | S Q:30 /30Days |
IONOSOL MB-D5W IV SOLUTION ![Compare how all Medicare Part D PDP plans in AZ cover IONOSOL MB-D5W IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IPOL VIAL 40;8;32; UNT ![Compare how all Medicare Part D PDP plans in AZ cover IPOL VIAL 40;8;32; UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IPRATROPIUM 0.06% SPRAY ![Compare how all Medicare Part D PDP plans in AZ cover IPRATROPIUM 0.06% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:15 /10Days |
IPRATROPIUM BR 0.02% SOLN ![Compare how all Medicare Part D PDP plans in AZ cover IPRATROPIUM BR 0.02% SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
IPRATROPIUM BROMIDE NASAL SPRAY ![Compare how all Medicare Part D PDP plans in AZ cover IPRATROPIUM BROMIDE NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | Q:30 /28Days |
IRBESARTAN 150 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in AZ cover IRBESARTAN 150 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IRBESARTAN 300 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in AZ cover IRBESARTAN 300 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IRBESARTAN 75 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in AZ cover IRBESARTAN 75 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in AZ cover IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in AZ cover IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IRESSA 250 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover IRESSA 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P Q:60 /30Days |
ISENTRESS 100 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in AZ cover ISENTRESS 100 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISENTRESS 100 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in AZ cover ISENTRESS 100 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISENTRESS 25 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in AZ cover ISENTRESS 25 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISENTRESS 400MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISENTRESS 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISENTRESS HD 600 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISENTRESS HD 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISIBLOOM 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in AZ cover ISIBLOOM 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOLYTE P IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in AZ cover ISOLYTE P IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOLYTE S IV SOLUTION-EXCEL ![Compare how all Medicare Part D PDP plans in AZ cover ISOLYTE S IV SOLUTION-EXCEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISONIAZID 100 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISONIAZID 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISONIAZID 300 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISONIAZID 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISONIAZID 50MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in AZ cover ISONIAZID 50MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE DINITRATE 40MG TABLETS ER ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE DINITRATE 40MG TABLETS ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOSORBIDE DN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE DN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE DN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE DN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE DN 30 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE DN 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE DN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE DN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE MN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE MN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE MN ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE MN ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE MN ER 60 MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE MN ER 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE MONONITRATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE MONONITRATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT) ![Compare how all Medicare Part D PDP plans in AZ cover ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOTON GENTAMICIN 80MG/100ML ![Compare how all Medicare Part D PDP plans in AZ cover ISOTON GENTAMICIN 80MG/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ISOTONIC GENTAMICIN 100 MG/100 ML ![Compare how all Medicare Part D PDP plans in AZ cover ISOTONIC GENTAMICIN 100 MG/100 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOTONIC GENTAMICIN 80 MG/50 ML ![Compare how all Medicare Part D PDP plans in AZ cover ISOTONIC GENTAMICIN 80 MG/50 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
ITRACONAZOLE 100 MG CAPSULE [Sporanox] ![Compare how all Medicare Part D PDP plans in AZ cover ITRACONAZOLE 100 MG CAPSULE [Sporanox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
IVERMECTIN 3 MG TABLET [Stromectol, Sklice] ![Compare how all Medicare Part D PDP plans in AZ cover IVERMECTIN 3 MG TABLET [Stromectol, Sklice].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |
Ixekizumab 1ML 80 MG/ML Auto-Injector [Taltz] ![Compare how all Medicare Part D PDP plans in AZ cover Ixekizumab 1ML 80 MG/ML Auto-Injector [Taltz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
Ixekizumab 1ML 80 MG/ML Prefilled Syringe [Taltz] ![Compare how all Medicare Part D PDP plans in AZ cover Ixekizumab 1ML 80 MG/ML Prefilled Syringe [Taltz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | P |
IXIARO JAPANESE ENCEPHALITIS VACCINE 6MCG/.5ML ![Compare how all Medicare Part D PDP plans in AZ cover IXIARO JAPANESE ENCEPHALITIS VACCINE 6MCG/.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All Formulary Drugs |
15% | 15% | None |