2019 Medicare Part D Plan Formulary Information |
Network PlatinumSelect (PPO) (H5215-008-0)
Benefit Details
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The Network PlatinumSelect (PPO) (H5215-008-0) Formulary Drugs Starting with the Letter A in Kewaunee County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $0.00 Deductible: $395 |
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ABACAVIR 20 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ABACAVIR 20 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in WI cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABACAVIR-LAMIVUDINE 600-300 MG ![Compare how all Medicare Part D PDP plans in WI cover ABACAVIR-LAMIVUDINE 600-300 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABELCET INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in WI cover ABELCET INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ABILIFY 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
ABILIFY 15MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
ABILIFY 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
ABILIFY 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
ABILIFY 30MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABILIFY 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
ABILIFY MAINTENA ER 300 MG SYR ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY MAINTENA ER 300 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABILIFY MAINTENA ER 300 MG VL ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY MAINTENA ER 300 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABILIFY MAINTENA ER 400 MG SUSER VIAL ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY MAINTENA ER 400 MG SUSER VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABILIFY MAINTENA ER 400 MG SYR ![Compare how all Medicare Part D PDP plans in WI cover ABILIFY MAINTENA ER 400 MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABIRATERONE ACETATE 250 MG TABLET [ZYTIGA] ![Compare how all Medicare Part D PDP plans in WI cover ABIRATERONE ACETATE 250 MG TABLET [ZYTIGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:120 /30Days |
ABSORICA 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ABSORICA 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABSORICA 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ABSORICA 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABSORICA 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ABSORICA 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABSORICA 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ABSORICA 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABSORICA 35 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ABSORICA 35 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABSORICA 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ABSORICA 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ABSTRAL 100 MCG TAB SUBLINGUAL ![Compare how all Medicare Part D PDP plans in WI cover ABSTRAL 100 MCG TAB SUBLINGUAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ABSTRAL 200 MCG TAB SUBLINGUAL ![Compare how all Medicare Part D PDP plans in WI cover ABSTRAL 200 MCG TAB SUBLINGUAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ABSTRAL 300 MCG TAB SUBLINGUAL ![Compare how all Medicare Part D PDP plans in WI cover ABSTRAL 300 MCG TAB SUBLINGUAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ABSTRAL 400 MCG TAB SUBLINGUAL ![Compare how all Medicare Part D PDP plans in WI cover ABSTRAL 400 MCG TAB SUBLINGUAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ABSTRAL 600 MCG TAB SUBLINGUAL ![Compare how all Medicare Part D PDP plans in WI cover ABSTRAL 600 MCG TAB SUBLINGUAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ABSTRAL 800 MCG TAB SUBLINGUAL ![Compare how all Medicare Part D PDP plans in WI cover ABSTRAL 800 MCG TAB SUBLINGUAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in WI cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACANYA 25; 10mg/g; mg/g 1 BOTTLE, PUMP per CARTON / 50 g in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in WI cover ACANYA 25; 10mg/g; mg/g 1 BOTTLE, PUMP per CARTON / 50 g in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACARBOSE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACARBOSE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:90 /30Days |
ACARBOSE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACARBOSE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACARBOSE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACARBOSE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:180 /30Days |
ACCOLATE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCOLATE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCOLATE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCOLATE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCUPRIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCUPRIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCUPRIL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCUPRIL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCUPRIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCUPRIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCUPRIL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCUPRIL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCURETIC 10-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCURETIC 10-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCURETIC 20-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCURETIC 20-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACCURETIC 20-25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACCURETIC 20-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACEBUTOLOL 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ACEBUTOLOL 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACEBUTOLOL 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ACEBUTOLOL 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACETAMINOP-CODEINE 120-12 MG/5 ![Compare how all Medicare Part D PDP plans in WI cover ACETAMINOP-CODEINE 120-12 MG/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:4500 /30Days |
Acetaminophen 325 MG / Hydrocodone Bitartrate 5 MG Oral Tablet [Lorcet] ![Compare how all Medicare Part D PDP plans in WI cover Acetaminophen 325 MG / Hydrocodone Bitartrate 5 MG Oral Tablet [Lorcet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #2 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACETAMINOPHEN-COD #2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #3 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACETAMINOPHEN-COD #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:180 /30Days |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACETAZOLAMIDE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover ACETAZOLAMIDE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACETAZOLAMIDE ER 500 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover ACETAZOLAMIDE ER 500 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACETIC ACID 2% EAR SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ACETIC ACID 2% EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in WI cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Acetylcysteine 200 MG/ML Inhalant Solution ![Compare how all Medicare Part D PDP plans in WI cover Acetylcysteine 200 MG/ML Inhalant Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ACIPHEX 20MG TABLET EC ![Compare how all Medicare Part D PDP plans in WI cover ACIPHEX 20MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in WI cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in WI cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in WI cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ACTEMRA 162 MG/0.9 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ACTEMRA 162 MG/0.9 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ACTEMRA ACTPEN 162 MG/0.9 ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in WI cover ACTEMRA ACTPEN 162 MG/0.9 ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ACTHIB VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in WI cover ACTHIB VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ACTIGALL 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ACTIGALL 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ACTIQ 1200MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WI cover ACTIQ 1200MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTIQ 1600MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WI cover ACTIQ 1600MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ACTIQ 200MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WI cover ACTIQ 200MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ACTIQ 400MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WI cover ACTIQ 400MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ACTIQ 600MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WI cover ACTIQ 600MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ACTIQ 800MCG LOZENGE ![Compare how all Medicare Part D PDP plans in WI cover ACTIQ 800MCG LOZENGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ACTIVELLA 0.5-0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTIVELLA 0.5-0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACTIVELLA 1 MG-0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTIVELLA 1 MG-0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACTONEL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTONEL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:1 /30Days |
ACTONEL 35 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTONEL 35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:5 /30Days |
ACTONEL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTONEL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ACTOPLUS MET 15MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTOPLUS MET 15MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACTOPLUS MET 15MG/850MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTOPLUS MET 15MG/850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:90 /30Days |
ACTOS 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTOS 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:30 /30Days |
ACTOS 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTOS 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:30 /30Days |
ACTOS 45 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACTOS 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:30 /30Days |
ACULAR 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ACULAR 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACULAR LS 0.4% OPHTH SOL ![Compare how all Medicare Part D PDP plans in WI cover ACULAR LS 0.4% OPHTH SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACUVAIL 0.45% OPHTH SOLUTION #30X0.4 EA ![Compare how all Medicare Part D PDP plans in WI cover ACUVAIL 0.45% OPHTH SOLUTION #30X0.4 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ACYCLOVIR 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ACYCLOVIR 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACYCLOVIR 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover ACYCLOVIR 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACYCLOVIR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACYCLOVIR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ACYCLOVIR 5% CREAM (g) [Zovirax] ![Compare how all Medicare Part D PDP plans in WI cover ACYCLOVIR 5% CREAM (g) [Zovirax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:5 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Acyclovir 5% Ointment ![Compare how all Medicare Part D PDP plans in WI cover Acyclovir 5% Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:30 /30Days |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in WI cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ACZONE 5% GEL ![Compare how all Medicare Part D PDP plans in WI cover ACZONE 5% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADACEL TDAP SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ADACEL TDAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in WI cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ADALAT CC 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADALAT CC 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADALAT CC 60 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADALAT CC 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADALAT CC 90 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADALAT CC 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in WI cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:2 /28Days |
ADAPALENE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover ADAPALENE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADAPALENE 0.1% GEL ![Compare how all Medicare Part D PDP plans in WI cover ADAPALENE 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ADAPALENE 0.1% SOLUTION [Plixda] ![Compare how all Medicare Part D PDP plans in WI cover ADAPALENE 0.1% SOLUTION [Plixda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADAPALENE 0.1% SWAB MED. SWAB [Plixda] ![Compare how all Medicare Part D PDP plans in WI cover ADAPALENE 0.1% SWAB MED. SWAB [Plixda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Adapalene 0.3% gel ![Compare how all Medicare Part D PDP plans in WI cover Adapalene 0.3% gel.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ADAPALENE-BNZYL PEROX 0.1-2.5% [EPIDUO] ![Compare how all Medicare Part D PDP plans in WI cover ADAPALENE-BNZYL PEROX 0.1-2.5% [EPIDUO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
ADCIRCA TABLETS 20MG 60 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover ADCIRCA TABLETS 20MG 60 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
ADDERALL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL XR 10MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL XR 10MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL XR 15MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL XR 15MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADDERALL XR 20MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL XR 20MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL XR 25MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL XR 25MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL XR 30MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL XR 30MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADDERALL XR 5MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover ADDERALL XR 5MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera] ![Compare how all Medicare Part D PDP plans in WI cover ADEFOVIR DIPIVOXIL 10 MG TAB [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ADLYXIN 10-20 MCG STARTER PACK ![Compare how all Medicare Part D PDP plans in WI cover ADLYXIN 10-20 MCG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:6 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADLYXIN 20 MCG MAINTENANCE PK ![Compare how all Medicare Part D PDP plans in WI cover ADLYXIN 20 MCG MAINTENANCE PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:6 /28Days |
ADMELOG 100 UNIT/ML VIAL [Humalog] ![Compare how all Medicare Part D PDP plans in WI cover ADMELOG 100 UNIT/ML VIAL [Humalog].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ADMELOG SOLOSTAR 100 UNIT/ML INSULN PEN [Humalog KwikPen] ![Compare how all Medicare Part D PDP plans in WI cover ADMELOG SOLOSTAR 100 UNIT/ML INSULN PEN [Humalog KwikPen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in WI cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in WI cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in WI cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in WI cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:12 /30Days |
ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL ![Compare how all Medicare Part D PDP plans in WI cover ADVAIR HFA INHALER 115;21MCG;MCG 120ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:12 /30Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in WI cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:12 /30Days |
ADZENYS ER 1.25 MG/ML SUSP BP 24H ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS ER 1.25 MG/ML SUSP BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADZENYS XR-ODT 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS XR-ODT 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADZENYS XR-ODT 15.7 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS XR-ODT 15.7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADZENYS XR-ODT 18.8 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS XR-ODT 18.8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADZENYS XR-ODT 3.1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS XR-ODT 3.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADZENYS XR-ODT 6.3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS XR-ODT 6.3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ADZENYS XR-ODT 9.4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ADZENYS XR-ODT 9.4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in WI cover AFINITOR TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFINITOR TABLETS 2.5 MG ![Compare how all Medicare Part D PDP plans in WI cover AFINITOR TABLETS 2.5 MG.](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 |
AFINITOR TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in WI cover AFINITOR TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AFREZZA 12 UNIT CARTRIDGE CART INHAL ![Compare how all Medicare Part D PDP plans in WI cover AFREZZA 12 UNIT CARTRIDGE CART INHAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AFREZZA 4 UNIT/8 UNIT/12 UNIT ![Compare how all Medicare Part D PDP plans in WI cover AFREZZA 4 UNIT/8 UNIT/12 UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AFREZZA 4 UNITS CARTRIDGE INH ![Compare how all Medicare Part D PDP plans in WI cover AFREZZA 4 UNITS CARTRIDGE INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AFREZZA 8 UNIT CARTRIDGE CART INHAL ![Compare how all Medicare Part D PDP plans in WI cover AFREZZA 8 UNIT CARTRIDGE CART INHAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AFREZZA 90-4 UNIT / 90-8 UNIT ![Compare how all Medicare Part D PDP plans in WI cover AFREZZA 90-4 UNIT / 90-8 UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AFREZZA 90-8 UNIT / 90-12 UNIT CART INHAL ![Compare how all Medicare Part D PDP plans in WI cover AFREZZA 90-8 UNIT / 90-12 UNIT CART INHAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AGGRENOX 25-200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AGGRENOX 25-200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AGRYLIN 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AGRYLIN 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AIMOVIG 140 MG/ML AUTOINJECTOR ![Compare how all Medicare Part D PDP plans in WI cover AIMOVIG 140 MG/ML AUTOINJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P Q:1 /30Days |
AIMOVIG 70 MG/ML AUTOINJECTOR ![Compare how all Medicare Part D PDP plans in WI cover AIMOVIG 70 MG/ML AUTOINJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P Q:2 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AIRDUO RESPICLICK 113-14 MCG ![Compare how all Medicare Part D PDP plans in WI cover AIRDUO RESPICLICK 113-14 MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
AIRDUO RESPICLICK 232-14 MCG ![Compare how all Medicare Part D PDP plans in WI cover AIRDUO RESPICLICK 232-14 MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
AIRDUO RESPICLICK 55-14 MCG ![Compare how all Medicare Part D PDP plans in WI cover AIRDUO RESPICLICK 55-14 MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
AJOVY 225 MG/1.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover AJOVY 225 MG/1.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P Q:1 /30Days |
AKTIPAK 3%-5% GEL POUCH ![Compare how all Medicare Part D PDP plans in WI cover AKTIPAK 3%-5% GEL POUCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Ala-cort 2.5% cream ![Compare how all Medicare Part D PDP plans in WI cover Ala-cort 2.5% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALA-SCALP HP 2% LOTION ![Compare how all Medicare Part D PDP plans in WI cover ALA-SCALP HP 2% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALBENDAZOLE 200 MG TABLET [Albenza] ![Compare how all Medicare Part D PDP plans in WI cover ALBENDAZOLE 200 MG TABLET [Albenza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:120 /30Days |
ALBENZA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALBENZA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:120 /30Days |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:17 /30Days |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:36 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:13 /30Days |
ALBUTEROL SUL 2.5 MG/3 ML SOLN ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SUL 2.5 MG/3 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE 0.75mg/3mL 30 POUCH per CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 3 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE 1.25MG/3ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ALBUTEROL SULFATE 2 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE 2 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALBUTEROL SULFATE 4 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE 4 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE INHALATION SOLUTION 0.5% 20ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT ![Compare how all Medicare Part D PDP plans in WI cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALCLOMETASONE DIPR 0.05% OINT ![Compare how all Medicare Part D PDP plans in WI cover ALCLOMETASONE DIPR 0.05% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALCLOMETASONE DIPRO 0.05% CRM ![Compare how all Medicare Part D PDP plans in WI cover ALCLOMETASONE DIPRO 0.05% CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALDACTAZIDE 25/25 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALDACTAZIDE 25/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ALDACTAZIDE 50/50 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALDACTAZIDE 50/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ALDACTONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALDACTONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ALDACTONE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALDACTONE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ALDACTONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALDACTONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ALDARA 5% CREAM ![Compare how all Medicare Part D PDP plans in WI cover ALDARA 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALECENSA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ALECENSA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:240 /30Days |
ALENDRONATE SODIUM 10 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover ALENDRONATE SODIUM 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ALENDRONATE SODIUM 35 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in WI cover ALENDRONATE SODIUM 35 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:5 /30Days |
ALENDRONATE SODIUM 40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALENDRONATE SODIUM 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALENDRONATE SODIUM 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ALENDRONATE SODIUM 70 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in WI cover ALENDRONATE SODIUM 70 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:5 /30Days |
ALENDRONATE SODIUM 70 MG/75 ML ![Compare how all Medicare Part D PDP plans in WI cover ALENDRONATE SODIUM 70 MG/75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:375 /30Days |
ALFUZOSIN HCL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALFUZOSIN HCL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALINIA 100 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover ALINIA 100 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Aliskiren 150 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in WI cover Aliskiren 150 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Aliskiren 150 MG / Hydrochlorothiazide 25 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in WI cover Aliskiren 150 MG / Hydrochlorothiazide 25 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALISKIREN 150 MG TABLET [Tekturna] ![Compare how all Medicare Part D PDP plans in WI cover ALISKIREN 150 MG TABLET [Tekturna].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Aliskiren 300 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in WI cover Aliskiren 300 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALISKIREN 300 MG TABLET [Tekturna] ![Compare how all Medicare Part D PDP plans in WI cover ALISKIREN 300 MG TABLET [Tekturna].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALLOPURINOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALLOPURINOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALLOPURINOL 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALLOPURINOL 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALLZITAL 25-325 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALLZITAL 25-325 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:360 /30Days |
ALMOTRIPTAN MALATE 12.5 MG TAB [Axert] ![Compare how all Medicare Part D PDP plans in WI cover ALMOTRIPTAN MALATE 12.5 MG TAB [Axert].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:9 /30Days |
ALMOTRIPTAN MALATE 6.25 MG TAB [Axert] ![Compare how all Medicare Part D PDP plans in WI cover ALMOTRIPTAN MALATE 6.25 MG TAB [Axert].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:9 /30Days |
ALOCRIL 2% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ALOCRIL 2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALOGLIPTIN 12.5 MG TABLET [Nesina] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN 12.5 MG TABLET [Nesina].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN 25 MG TABLET [Nesina] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN 25 MG TABLET [Nesina].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN 6.25 MG TABLET [Nesina] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN 6.25 MG TABLET [Nesina].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN-METFORMIN 12.5-1000 [Kazano] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-METFORMIN 12.5-1000 [Kazano].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:60 /30Days |
ALOGLIPTIN-METFORMIN 12.5-500 [Kazano] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-METFORMIN 12.5-500 [Kazano].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALOGLIPTIN-PIOGLIT 12.5-15 MG [Oseni] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-PIOGLIT 12.5-15 MG [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN-PIOGLIT 12.5-30 MG [Oseni] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-PIOGLIT 12.5-30 MG [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN-PIOGLIT 12.5-45 MG [Oseni] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-PIOGLIT 12.5-45 MG [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN-PIOGLIT 25-15 MG TABLET [Oseni] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-PIOGLIT 25-15 MG TABLET [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN-PIOGLIT 25-30 MG TABLET [Oseni] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-PIOGLIT 25-30 MG TABLET [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOGLIPTIN-PIOGLIT 25-45 MG TABLET [Oseni] ![Compare how all Medicare Part D PDP plans in WI cover ALOGLIPTIN-PIOGLIT 25-45 MG TABLET [Oseni].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:30 /30Days |
ALOMIDE 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ALOMIDE 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALORA 0.025 MG PATCH TDSW [Vivelle-Dot] ![Compare how all Medicare Part D PDP plans in WI cover ALORA 0.025 MG PATCH TDSW [Vivelle-Dot].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALORA 0.05 MG PATCH ![Compare how all Medicare Part D PDP plans in WI cover ALORA 0.05 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALORA 0.075 MG PATCH ![Compare how all Medicare Part D PDP plans in WI cover ALORA 0.075 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALORA 0.1 MG PATCH ![Compare how all Medicare Part D PDP plans in WI cover ALORA 0.1 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALOSETRON HCL 0.5 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in WI cover ALOSETRON HCL 0.5 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ALOSETRON HCL 1 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in WI cover ALOSETRON HCL 1 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ALPHAGAN P 0.1% DROPS ![Compare how all Medicare Part D PDP plans in WI cover ALPHAGAN P 0.1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALPHAGAN P 0.15% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ALPHAGAN P 0.15% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALPRAZOLAM 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Alprazolam 1mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Alprazolam 1mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Alprazolam 1mg/mL 1 BOTTLE in 1 CONTAINER / 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Alprazolam 1mg/mL 1 BOTTLE in 1 CONTAINER / 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Alprazolam 2mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Alprazolam 2mg/1 10 BLISTER PACK per CARTON / 10 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALPRAZOLAM ER 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM ER 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM ER 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM ER 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM ER 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM ER 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM ER 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM ER 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM ODT 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM ODT 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALPRAZOLAM ODT 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALPRAZOLAM ODT 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALTACE 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ALTACE 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALTACE 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover ALTACE 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALTACE 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ALTACE 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALTACE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ALTACE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALTAVERA-28 TABLET [Portia] ![Compare how all Medicare Part D PDP plans in WI cover ALTAVERA-28 TABLET [Portia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ALTOPREV 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALTOPREV 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALTOPREV 60 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALTOPREV 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ALTRENO 0.05% LOTION ![Compare how all Medicare Part D PDP plans in WI cover ALTRENO 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ALUNBRIG 180 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALUNBRIG 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
ALUNBRIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALUNBRIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:180 /30Days |
ALUNBRIG 90 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALUNBRIG 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
ALUNBRIG 90 MG-180 MG TABLET PACK ![Compare how all Medicare Part D PDP plans in WI cover ALUNBRIG 90 MG-180 MG TABLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
ALVESCO 160 MCG INHALER HFA AER AD ![Compare how all Medicare Part D PDP plans in WI cover ALVESCO 160 MCG INHALER HFA AER AD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:12 /30Days |
ALVESCO 80 MCG INHALER HFA AER AD ![Compare how all Medicare Part D PDP plans in WI cover ALVESCO 80 MCG INHALER HFA AER AD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:12 /30Days |
ALYACEN 1-35-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALYACEN 1-35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALYQ 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ALYQ 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Amabelz 0.5 MG/0.1 MG 28 TABLET/BLISTER PACK 3 PER CARTON ![Compare how all Medicare Part D PDP plans in WI cover Amabelz 0.5 MG/0.1 MG 28 TABLET/BLISTER PACK 3 PER CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Amabelz 1 MG/0.5 MG 28 TABLET/BLISTER PACK 3 PER CARTON ![Compare how all Medicare Part D PDP plans in WI cover Amabelz 1 MG/0.5 MG 28 TABLET/BLISTER PACK 3 PER CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMANTADINE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMANTADINE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMANTADINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMANTADINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMANTADINE 50 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover AMANTADINE 50 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMARYL 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMARYL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:240 /30Days |
AMARYL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMARYL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:120 /30Days |
AMARYL 4MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMARYL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
AMBIEN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMBIEN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
AMBIEN CR 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMBIEN CR 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMBIEN CR 6.25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMBIEN CR 6.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
AMBIEN TABLETS 5MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover AMBIEN TABLETS 5MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
AMBISOME 50MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover AMBISOME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AMBRISENTAN 10 MG TABLET [LETAIRIS] ![Compare how all Medicare Part D PDP plans in WI cover AMBRISENTAN 10 MG TABLET [LETAIRIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
AMBRISENTAN 5 MG TABLET [LETAIRIS] ![Compare how all Medicare Part D PDP plans in WI cover AMBRISENTAN 5 MG TABLET [LETAIRIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
AMCINONIDE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover AMCINONIDE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMCINONIDE 0.1% LOTION ![Compare how all Medicare Part D PDP plans in WI cover AMCINONIDE 0.1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMCINONIDE 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover AMCINONIDE 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMERGE 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMERGE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:9 /30Days |
AMERGE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMERGE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:9 /30Days |
AMETHIA 0.15-0.03-0.01 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMETHIA 0.15-0.03-0.01 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMETHIA LO TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMETHIA LO TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMIKACIN SULF 500 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover AMIKACIN SULF 500 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AMILORIDE HCL 5 MG TABLET [Midamor] ![Compare how all Medicare Part D PDP plans in WI cover AMILORIDE HCL 5 MG TABLET [Midamor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMILORIDE HCL-HCTZ 5-50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMILORIDE HCL-HCTZ 5-50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Amino Acids 15% Solution ![Compare how all Medicare Part D PDP plans in WI cover Amino Acids 15% Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10] ![Compare how all Medicare Part D PDP plans in WI cover Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5] ![Compare how all Medicare Part D PDP plans in WI cover Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Amino acids 4.25% with electrolytes in dextrose 10% Injectable Solution [Clinimix E 4.25/10] ![Compare how all Medicare Part D PDP plans in WI cover Amino acids 4.25% with electrolytes in dextrose 10% Injectable Solution [Clinimix E 4.25/10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
AMINOSYN II 10% SOL 6X2000 ML ![Compare how all Medicare Part D PDP plans in WI cover AMINOSYN II 10% SOL 6X2000 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMINOSYN PF INJECTION ![Compare how all Medicare Part D PDP plans in WI cover AMINOSYN PF INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMIODARONE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMIODARONE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMIODARONE HCL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMIODARONE HCL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMIODARONE HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMIODARONE HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AMITIZA CAPSULES 24MCG 60 CAP BOT ![Compare how all Medicare Part D PDP plans in WI cover AMITIZA CAPSULES 24MCG 60 CAP BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMITRIP/PERPHEN 10-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMITRIPTYLINE HCL 10 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMITRIPTYLINE HCL 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMITRIPTYLINE HCL 100 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMITRIPTYLINE HCL 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL 150 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMITRIPTYLINE HCL 150 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMITRIPTYLINE HCL 25 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMITRIPTYLINE HCL 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMITRIPTYLINE HCL 50 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMITRIPTYLINE HCL 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMITRIPTYLINE HCL 75 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMITRIPTYLINE HCL 75 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMLOD-VALSA-HCTZ 10-160-12.5MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in WI cover AMLOD-VALSA-HCTZ 10-160-12.5MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMLOD-VALSA-HCTZ 10-160-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in WI cover AMLOD-VALSA-HCTZ 10-160-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMLOD-VALSA-HCTZ 10-320-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in WI cover AMLOD-VALSA-HCTZ 10-320-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMLOD-VALSA-HCTZ 5-160-12.5 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in WI cover AMLOD-VALSA-HCTZ 5-160-12.5 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLOD-VALSA-HCTZ 5-160-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in WI cover AMLOD-VALSA-HCTZ 5-160-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE BESYLATE 10 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE BESYLATE 10 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
AMLODIPINE BESYLATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE BESYLATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE BESYLATE 5 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE BESYLATE 5 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
AMLODIPINE-ATORVAST 10-20 MG [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-ATORVAST 10-20 MG [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMLODIPINE-ATORVAST 10-40 MG [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-ATORVAST 10-40 MG [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Amlodipine-Atorvastatin 10-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 10-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Amlodipine-Atorvastatin 10-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 10-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Amlodipine-Atorvastatin 2.5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 2.5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 2.5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 2.5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Amlodipine-Atorvastatin 2.5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 2.5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Amlodipine-Atorvastatin 5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Amlodipine-Atorvastatin 5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Amlodipine-Atorvastatin 5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amlodipine-Atorvastatin 5-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in WI cover Amlodipine-Atorvastatin 5-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMLODIPINE-BENAZEPRIL 10-20 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-BENAZEPRIL 10-20 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 10-40 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-BENAZEPRIL 10-40 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 2.5-10 Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-BENAZEPRIL 2.5-10 Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-10 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-BENAZEPRIL 5-10 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-20 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-BENAZEPRIL 5-20 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-BENAZEPRIL 5-40 MG Capsule [Lotrel] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-BENAZEPRIL 5-40 MG Capsule [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-OLMESARTAN 10-20 MG [Azor] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-OLMESARTAN 10-20 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-OLMESARTAN 10-40 MG [Azor] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-OLMESARTAN 10-40 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-OLMESARTAN 5-20 MG [Azor] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-OLMESARTAN 5-20 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-OLMESARTAN 5-40 MG [Azor] ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-OLMESARTAN 5-40 MG [Azor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE-VALSARTAN 10-160 MG ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-VALSARTAN 10-160 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-VALSARTAN 10-320 MG ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-VALSARTAN 10-320 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-VALSARTAN 5-160 MG ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-VALSARTAN 5-160 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMLODIPINE-VALSARTAN 5-320 MG ![Compare how all Medicare Part D PDP plans in WI cover AMLODIPINE-VALSARTAN 5-320 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMMONIUM LACTATE 12% CREAM ![Compare how all Medicare Part D PDP plans in WI cover AMMONIUM LACTATE 12% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in WI cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMNESTEEM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMNESTEEM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMNESTEEM 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMNESTEEM 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AMNESTEEM 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMNESTEEM 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in WI cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in WI cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in WI cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV 200-28.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV 200-28.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV 250-62.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV 250-62.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV 400-57 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV 400-57 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV 500-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV 500-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV 600-42.9 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV 600-42.9 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV 875-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV 875-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in WI cover AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 250 MG TAB CHEW ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 250 MG TAB CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 400 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 400 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMOXICILLIN 875 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMOXICILLIN 875 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMPHETAMINE SALTS 5 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover AMPHETAMINE SALTS 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMPHETAMINE SULFATE 10 MG TABLET [Evekeo] ![Compare how all Medicare Part D PDP plans in WI cover AMPHETAMINE SULFATE 10 MG TABLET [Evekeo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AMPHETAMINE SULFATE 5 MG TABLET [Evekeo] ![Compare how all Medicare Part D PDP plans in WI cover AMPHETAMINE SULFATE 5 MG TABLET [Evekeo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
AMPICILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in WI cover AMPICILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Ampicillin 1000 MG / Sulbactam 500 MG Injection ![Compare how all Medicare Part D PDP plans in WI cover Ampicillin 1000 MG / Sulbactam 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Ampicillin 1000 MG Injection ![Compare how all Medicare Part D PDP plans in WI cover Ampicillin 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in WI cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ampicillin 2000 MG / Sulbactam 1000 MG Injection ![Compare how all Medicare Part D PDP plans in WI cover Ampicillin 2000 MG / Sulbactam 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover AMPICILLIN CAPSULES 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AMPICILLIN-SULBACTAM 15 GM VL ![Compare how all Medicare Part D PDP plans in WI cover AMPICILLIN-SULBACTAM 15 GM VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AMPYRA ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AMPYRA ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
AMRIX 30 MG ![Compare how all Medicare Part D PDP plans in WI cover AMRIX 30 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AMRIX CAPSULES EXTENDED RELEASE 15MG 60 CAPSULES BOT ![Compare how all Medicare Part D PDP plans in WI cover AMRIX CAPSULES EXTENDED RELEASE 15MG 60 CAPSULES BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ANADROL-50 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ANADROL-50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ANAFRANIL 25 MG 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover ANAFRANIL 25 MG 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ANAFRANIL 50 MG 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover ANAFRANIL 50 MG 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ANAFRANIL 75 MG 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover ANAFRANIL 75 MG 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ANASTROZOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ANASTROZOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ANCOBON 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ANCOBON 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ANCOBON 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ANCOBON 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ANDRODERM 2 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover ANDRODERM 2 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ANDRODERM 4 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover ANDRODERM 4 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ANDROGEL 1.62% (1.25G) GEL PCKT ![Compare how all Medicare Part D PDP plans in WI cover ANDROGEL 1.62% (1.25G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
ANDROGEL 1.62% (2.5G) GEL PCKT ![Compare how all Medicare Part D PDP plans in WI cover ANDROGEL 1.62% (2.5G) GEL PCKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
ANDROGEL 1% (50MG) GEL PACKET ![Compare how all Medicare Part D PDP plans in WI cover ANDROGEL 1% (50MG) GEL PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Androgel 10mg/g 30 PACKET in 1 CARTON / 2.5 g in 1 PACKET ![Compare how all Medicare Part D PDP plans in WI cover Androgel 10mg/g 30 PACKET in 1 CARTON / 2.5 g in 1 PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP ![Compare how all Medicare Part D PDP plans in WI cover Androgel 16.2mg/g 1 BOTTLE, PUMP per CARTON / 88 g in 1 BOTTLE, PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ANDROID 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ANDROID 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Angeliq 0.25/0.5 28 Day Pack ![Compare how all Medicare Part D PDP plans in WI cover Angeliq 0.25/0.5 28 Day Pack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ANGELIQ 1-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ANGELIQ 1-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in WI cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
ANTABUSE 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ANTABUSE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ANTABUSE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ANTABUSE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ANTARA 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ANTARA 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ANTARA 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ANTARA 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ANUSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in WI cover ANUSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APEXICON E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WI cover APEXICON E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
APIDRA 100 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover APIDRA 100 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APIDRA SOLOSTAR 100 UNITS/ML ![Compare how all Medicare Part D PDP plans in WI cover APIDRA SOLOSTAR 100 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
APLENZIN ER 174 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APLENZIN ER 174 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APLENZIN ER 348 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APLENZIN ER 348 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APLENZIN ER 522 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APLENZIN ER 522 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in WI cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Apraclonidine 5 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in WI cover Apraclonidine 5 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
APREPITANT 125 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in WI cover APREPITANT 125 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:4 /28Days |
APREPITANT 125-80-80 MG PACK [Emend] ![Compare how all Medicare Part D PDP plans in WI cover APREPITANT 125-80-80 MG PACK [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:12 /28Days |
APREPITANT 40 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in WI cover APREPITANT 40 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
APREPITANT 80 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in WI cover APREPITANT 80 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:8 /28Days |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in WI cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APRISO CP24 ![Compare how all Medicare Part D PDP plans in WI cover APRISO CP24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
APTENSIO XR 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTENSIO XR 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTENSIO XR 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTENSIO XR 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTENSIO XR 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTENSIO XR 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTENSIO XR 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTENSIO XR 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S Q:30 /30Days |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S Q:30 /30Days |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | S Q:60 /30Days |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in WI cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARALAST NP 1,000 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover ARALAST NP 1,000 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ARANESP 10 MCG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 10 MCG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:2 /28Days |
ARANESP 100ug/0.5mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 100ug/0.5mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:2 /28Days |
ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
ARANESP 200MCG/0.4ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 200MCG/0.4ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARANESP 200MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 200MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARANESP 25ug/0.42mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.42 mL in 1 SYRING ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 25ug/0.42mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.42 mL in 1 SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:2 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP 25ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 25ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:4 /28Days |
ARANESP 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARANESP 500MCG/1ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 500MCG/1ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARANESP 60MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 60MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
ARANESP 60ug/0.3mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.3 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ARANESP 60ug/0.3mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.3 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:1 /28Days |
ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR ![Compare how all Medicare Part D PDP plans in WI cover ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR ![Compare how all Medicare Part D PDP plans in WI cover ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR ![Compare how all Medicare Part D PDP plans in WI cover ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:2 /28Days |
ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD ![Compare how all Medicare Part D PDP plans in WI cover ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P Q:4 /28Days |
ARAVA 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ARAVA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ARAVA 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ARAVA 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ARCAPTA NEOHALER 75 MCG CAP ![Compare how all Medicare Part D PDP plans in WI cover ARCAPTA NEOHALER 75 MCG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:30 /30Days |
ARICEPT 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ARICEPT 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ARICEPT 23 MG TABLETS ![Compare how all Medicare Part D PDP plans in WI cover ARICEPT 23 MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ARICEPT 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ARICEPT 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S |
ARIKAYCE 590 MG/8.4 ML VIAL-NEB ![Compare how all Medicare Part D PDP plans in WI cover ARIKAYCE 590 MG/8.4 ML VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARIMIDEX 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ARIMIDEX 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:750 /30Days |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:60 /30Days |
ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt] ![Compare how all Medicare Part D PDP plans in WI cover ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:60 /30Days |
ARISTADA ER 1064 MG/3.9 ML SYR ![Compare how all Medicare Part D PDP plans in WI cover ARISTADA ER 1064 MG/3.9 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA ER 441 MG/1.6 ML SYRN ![Compare how all Medicare Part D PDP plans in WI cover ARISTADA ER 441 MG/1.6 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA ER 662 MG/2.4 ML SYRN ![Compare how all Medicare Part D PDP plans in WI cover ARISTADA ER 662 MG/2.4 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA ER 882 MG/3.2 ML SYRN ![Compare how all Medicare Part D PDP plans in WI cover ARISTADA ER 882 MG/3.2 ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARISTADA INITIO ER 675 MG/2.4 SUSER SYR ![Compare how all Medicare Part D PDP plans in WI cover ARISTADA INITIO ER 675 MG/2.4 SUSER SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ARIXTRA 7.5 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ARIXTRA 7.5 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Armodafinil 150 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in WI cover Armodafinil 150 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Armodafinil 200 MG Oral Tablet [NUVIGIL] ![Compare how all Medicare Part D PDP plans in WI cover Armodafinil 200 MG Oral Tablet [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Armodafinil 250 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in WI cover Armodafinil 250 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
Armodafinil 50 MG TABLET [NUVIGIL] ![Compare how all Medicare Part D PDP plans in WI cover Armodafinil 50 MG TABLET [NUVIGIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
ARNUITY ELLIPTA 100 MCG INH ![Compare how all Medicare Part D PDP plans in WI cover ARNUITY ELLIPTA 100 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:30 /30Days |
ARNUITY ELLIPTA 200 MCG INH ![Compare how all Medicare Part D PDP plans in WI cover ARNUITY ELLIPTA 200 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:30 /30Days |
ARNUITY ELLIPTA 50 MCG INH BLST W/DEV ![Compare how all Medicare Part D PDP plans in WI cover ARNUITY ELLIPTA 50 MCG INH BLST W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:30 /30Days |
AROMASIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AROMASIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ARTHROTEC 50 50MG TABLET -200MCG (60 CT) ![Compare how all Medicare Part D PDP plans in WI cover ARTHROTEC 50 50MG TABLET -200MCG (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ARTHROTEC 75 TABLET EC ![Compare how all Medicare Part D PDP plans in WI cover ARTHROTEC 75 TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ASACOL HD DR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ASACOL HD DR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASCOMP WITH CODEINE CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ASCOMP WITH CODEINE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:360 /30Days |
ASHLYNA 0.15-0.03-0.01 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover ASHLYNA 0.15-0.03-0.01 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ASMANEX HFA 100 MCG INHALER ![Compare how all Medicare Part D PDP plans in WI cover ASMANEX HFA 100 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:13 /30Days |
ASMANEX HFA 200 MCG INHALER ![Compare how all Medicare Part D PDP plans in WI cover ASMANEX HFA 200 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:13 /30Days |
ASMANEX TWISTHALER 110 MCG #30 ![Compare how all Medicare Part D PDP plans in WI cover ASMANEX TWISTHALER 110 MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:30 /30Days |
ASMANEX TWISTHALER 220 MCG #30 ![Compare how all Medicare Part D PDP plans in WI cover ASMANEX TWISTHALER 220 MCG #30.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:30 /30Days |
ASMANEX TWISTHALER 220MCG #120 ![Compare how all Medicare Part D PDP plans in WI cover ASMANEX TWISTHALER 220MCG #120.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:120 /30Days |
ASMANEX TWISTHALER 220MCG #60 ![Compare how all Medicare Part D PDP plans in WI cover ASMANEX TWISTHALER 220MCG #60.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
Aspirin-Diphenhydramine ER 25-200 MG ![Compare how all Medicare Part D PDP plans in WI cover Aspirin-Diphenhydramine ER 25-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE ![Compare how all Medicare Part D PDP plans in WI cover ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:360 /30Days |
ASTAGRAF XL 0.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ASTAGRAF XL 0.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ASTAGRAF XL 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ASTAGRAF XL 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ASTAGRAF XL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ASTAGRAF XL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
ASTEPRO 0.15% NASAL SPRAY 30 ML ![Compare how all Medicare Part D PDP plans in WI cover ASTEPRO 0.15% NASAL SPRAY 30 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
ATACAND 16 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND 16 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATACAND 32 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND 32 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATACAND 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATACAND 8 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATACAND HCT 16-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND HCT 16-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATACAND HCT 32-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND HCT 32-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATACAND HCT 32-25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATACAND HCT 32-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATAZANAVIR SULFATE 150 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in WI cover ATAZANAVIR SULFATE 150 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATAZANAVIR SULFATE 200 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in WI cover ATAZANAVIR SULFATE 200 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ATAZANAVIR SULFATE 300 MG CAP [Reyataz] ![Compare how all Medicare Part D PDP plans in WI cover ATAZANAVIR SULFATE 300 MG CAP [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Atelvia 35mg/1 36 DOSE PACK CASE / 4 TABLET, DELAYED RELEASE in 1 DOSE PACK ![Compare how all Medicare Part D PDP plans in WI cover Atelvia 35mg/1 36 DOSE PACK CASE / 4 TABLET, DELAYED RELEASE in 1 DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | S Q:5 /30Days |
ATENOLOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATENOLOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ATENOLOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATENOLOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ATENOLOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATENOLOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in WI cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATIVAN 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATIVAN 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATIVAN 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATIVAN 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATIVAN 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATIVAN 1 MG TABLET .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATIVAN 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ATIVAN 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
ATOMOXETINE HCL 10 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 10 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOMOXETINE HCL 100 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 100 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOMOXETINE HCL 18 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 18 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOMOXETINE HCL 25 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 25 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOMOXETINE HCL 40 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 40 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOMOXETINE HCL 60 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 60 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOMOXETINE HCL 80 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in WI cover ATOMOXETINE HCL 80 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in WI cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in WI cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in WI cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in WI cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in WI cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in WI cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATOVAQUONE-PROGUANIL 62.5-25 [Malarone] ![Compare how all Medicare Part D PDP plans in WI cover ATOVAQUONE-PROGUANIL 62.5-25 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATRALIN 0.05% GEL ![Compare how all Medicare Part D PDP plans in WI cover ATRALIN 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ATROPINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ATROPINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in WI cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | Q:26 /30Days |
AUBAGIO 14 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AUBAGIO 14 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
AUBAGIO 7 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AUBAGIO 7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
AUBRA-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover AUBRA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AUGMENTIN 125-31.25 MG/5 ML ![Compare how all Medicare Part D PDP plans in WI cover AUGMENTIN 125-31.25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AURYXIA 210 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AURYXIA 210 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
AUSTEDO 12 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AUSTEDO 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AUSTEDO 6 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AUSTEDO 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AUSTEDO 9 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AUSTEDO 9 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
AVALIDE 150-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVALIDE 150-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVALIDE 300-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVALIDE 300-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVANDIA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVANDIA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
AVANDIA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVANDIA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | Q:60 /30Days |
AVAPRO 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVAPRO 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVAPRO 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVAPRO 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVAPRO 75 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVAPRO 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVC 15% CREAM ![Compare how all Medicare Part D PDP plans in WI cover AVC 15% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVEED 750 MG/3 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover AVEED 750 MG/3 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVELOX 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVELOX 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in WI cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AVITA 0.025% CREAM ![Compare how all Medicare Part D PDP plans in WI cover AVITA 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
Avita 0.25mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Avita 0.25mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | P |
AVODART 0.5 MG SOFTGEL ![Compare how all Medicare Part D PDP plans in WI cover AVODART 0.5 MG SOFTGEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AVONEX ADMIN PACK 30 MCG VL ![Compare how all Medicare Part D PDP plans in WI cover AVONEX ADMIN PACK 30 MCG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
AVONEX PEN 30 MCG/0.5 ML KIT ![Compare how all Medicare Part D PDP plans in WI cover AVONEX PEN 30 MCG/0.5 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
AVONEX PREFILLED SYR 30 MCG KT ![Compare how all Medicare Part D PDP plans in WI cover AVONEX PREFILLED SYR 30 MCG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVYCAZ 2.5 GRAM VIAL ![Compare how all Medicare Part D PDP plans in WI cover AVYCAZ 2.5 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Aygestin 5mg/1 50 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Aygestin 5mg/1 50 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZASAN 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZASAN 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AZASAN 75MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZASAN 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | P |
AZASITE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover AZASITE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZATHIOPRINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZATHIOPRINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | P |
AZELAIC ACID 15% GEL [Finacea] ![Compare how all Medicare Part D PDP plans in WI cover AZELAIC ACID 15% GEL [Finacea].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZELASTINE 0.15% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WI cover AZELASTINE 0.15% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:60 /30Days |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WI cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:60 /30Days |
AZELASTINE HCL 0.05% DROPS ![Compare how all Medicare Part D PDP plans in WI cover AZELASTINE HCL 0.05% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZELEX 20% CREAM 30GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover AZELEX 20% CREAM 30GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZILECT 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZILECT 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZILECT 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZILECT 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZITHROMYCIN 1 GM PWD PACKET ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 1 GM PWD PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak] ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN 600 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
AZITHROMYCIN I.V. 500 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover AZITHROMYCIN I.V. 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZOPT 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover AZOPT 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZOR 10-20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZOR 10-20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZOR 10MG-40MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover AZOR 10MG-40MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZOR 5-40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZOR 5-40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZOR 5MG-20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover AZOR 5MG-20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Aztreonam 1000 MG Injection [Azactam] ![Compare how all Medicare Part D PDP plans in WI cover Aztreonam 1000 MG Injection [Azactam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
Aztreonam 2000 MG Injection [Azactam] ![Compare how all Medicare Part D PDP plans in WI cover Aztreonam 2000 MG Injection [Azactam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $105.00 | None |
AZULFIDINE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover AZULFIDINE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |
AZULFIDINE ENTAB 500 MG ![Compare how all Medicare Part D PDP plans in WI cover AZULFIDINE ENTAB 500 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$84.00 | $210.00 | None |