2019 Medicare Part D Plan Formulary Information |
HumanaChoice H5216-124 (PPO) (H5216-124-0)
Benefit Details
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The HumanaChoice H5216-124 (PPO) (H5216-124-0) Formulary Drugs Starting with the Letter E in Lincoln County, WV: CMS MA Region 6 which includes: WV Plan Monthly Premium: $123.00 Deductible: $0 |
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ECONAZOLE NITRATE 1% CREAM 85GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover ECONAZOLE NITRATE 1% CREAM 85GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in WV cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
EFAVIRENZ 200 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in WV cover EFAVIRENZ 200 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:120 /30Days |
EFAVIRENZ 50 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in WV cover EFAVIRENZ 50 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:480 /30Days |
EFAVIRENZ 600 MG TABLET [Sustiva] ![Compare how all Medicare Part D PDP plans in WV cover EFAVIRENZ 600 MG TABLET [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
EFFIENT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EFFIENT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:30 /30Days |
EFFIENT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EFFIENT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:30 /30Days |
EGRIFTA 2 MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover EGRIFTA 2 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
ELIDEL 1% CREAM ![Compare how all Medicare Part D PDP plans in WV cover ELIDEL 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ELIGARD 22.5 MG SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ELIGARD 22.5 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIGARD 30 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in WV cover ELIGARD 30 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ELIGARD 45 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in WV cover ELIGARD 45 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ELIGARD 7.5 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in WV cover ELIGARD 7.5 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ELIQUIS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ELIQUIS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
ELIQUIS 5 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in WV cover ELIQUIS 5 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:74 /30Days |
ELIQUIS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ELIQUIS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:74 /30Days |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:90 /30Days |
EMBEDA ER 100-4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMBEDA ER 100-4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
EMBEDA ER 20-0.8 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMBEDA ER 20-0.8 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
EMBEDA ER 30-1.2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMBEDA ER 30-1.2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
EMBEDA ER 50-2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMBEDA ER 50-2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMBEDA ER 60-2.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMBEDA ER 60-2.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
EMBEDA ER 80-3.2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMBEDA ER 80-3.2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
EMGALITY 120 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in WV cover EMGALITY 120 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:2 /30Days |
EMGALITY 120 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover EMGALITY 120 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:2 /30Days |
EMOQUETTE 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WV cover EMOQUETTE 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy] ![Compare how all Medicare Part D PDP plans in WV cover Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in WV cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in WV cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in WV cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:680 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
ENALAPRIL MALEATE 10 MG TAB ![Compare how all Medicare Part D PDP plans in WV cover ENALAPRIL MALEATE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ENALAPRIL MALEATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in WV cover ENALAPRIL MALEATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ENALAPRIL MALEATE 20 MG TAB ![Compare how all Medicare Part D PDP plans in WV cover ENALAPRIL MALEATE 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WV cover Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ENALAPRIL-HCTZ 5-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in WV cover ENALAPRIL-HCTZ 5-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ENBREL 25 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:8 /28Days |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in WV cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:8 /28Days |
ENBREL 50 MG/ML SURECLICK SYR ![Compare how all Medicare Part D PDP plans in WV cover ENBREL 50 MG/ML SURECLICK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:8 /28Days |
ENBREL 50mg/mL ![Compare how all Medicare Part D PDP plans in WV cover ENBREL 50mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:8 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in WV cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ENGERIX-B 20 MCG/ML SYRN ![Compare how all Medicare Part D PDP plans in WV cover ENGERIX-B 20 MCG/ML SYRN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ENOXAPARIN 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:28 /28Days |
ENOXAPARIN 120 MG/0.8 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 120 MG/0.8 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:22 /28Days |
ENOXAPARIN 150 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 150 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:28 /28Days |
ENOXAPARIN 30 MG/0.3 ML SYR ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 30 MG/0.3 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:17 /28Days |
ENOXAPARIN 40 MG/0.4 ML SYR ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 40 MG/0.4 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:11 /28Days |
ENOXAPARIN 60 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 60 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:17 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENOXAPARIN 80 MG/0.8 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WV cover ENOXAPARIN 80 MG/0.8 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:22 /28Days |
ENSKYCE 28 TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WV cover ENSKYCE 28 TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ENSTILAR 0.005%-0.064% FOAM ![Compare how all Medicare Part D PDP plans in WV cover ENSTILAR 0.005%-0.064% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:120 /30Days |
ENTACAPONE 200 MG TABLET [Comtan Entacapone] ![Compare how all Medicare Part D PDP plans in WV cover ENTACAPONE 200 MG TABLET [Comtan Entacapone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:300 /30Days |
ENTECAVIR 0.5 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in WV cover ENTECAVIR 0.5 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
ENTECAVIR 1 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in WV cover ENTECAVIR 1 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
ENTRESTO 24 MG-26 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENTRESTO 24 MG-26 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | P Q:60 /30Days |
ENTRESTO 49 MG-51 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENTRESTO 49 MG-51 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | P Q:60 /30Days |
ENTRESTO 97 MG-103 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ENTRESTO 97 MG-103 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | P Q:60 /30Days |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $0.00 | None |
EPCLUSA 400 MG-100 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EPCLUSA 400 MG-100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPIDIOLEX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover EPIDIOLEX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
EPINEPHRINE 0.15 MG AUTO-INJCT ![Compare how all Medicare Part D PDP plans in WV cover EPINEPHRINE 0.15 MG AUTO-INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:4 /30Days |
EPINEPHRINE 0.3 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in WV cover EPINEPHRINE 0.3 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:4 /30Days |
EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in WV cover EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:4 /30Days |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in WV cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Eplerenone 25mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Eplerenone 25mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Eplerenone 50mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WV cover Eplerenone 50mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
EPOGEN 10000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in WV cover EPOGEN 10000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:28 /30Days |
EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WV cover EPOGEN 2000[iU]/mL 10 VIAL in 1 PACKAGE / 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:14 /30Days |
EPOGEN 3000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in WV cover EPOGEN 3000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:14 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPOGEN 4000U/ML VIAL SDV ![Compare how all Medicare Part D PDP plans in WV cover EPOGEN 4000U/ML VIAL SDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:14 /30Days |
EPOGEN INJECTION 20000U 10 X 1ML CRTN ![Compare how all Medicare Part D PDP plans in WV cover EPOGEN INJECTION 20000U 10 X 1ML CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:14 /30Days |
EQUETRO CAPSULES 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in WV cover EQUETRO CAPSULES 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
EQUETRO CAPSULES 300MG 120 BOT ![Compare how all Medicare Part D PDP plans in WV cover EQUETRO CAPSULES 300MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT ![Compare how all Medicare Part D PDP plans in WV cover EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in WV cover ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ERAXIS(WATER DIL) 50 MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover ERAXIS(WATER DIL) 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Ergotamine-caffeine 1-100mg tb ![Compare how all Medicare Part D PDP plans in WV cover Ergotamine-caffeine 1-100mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
ERLEADA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ERLEADA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
ERLOTINIB HCL 100 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in WV cover ERLOTINIB HCL 100 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERLOTINIB HCL 150 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in WV cover ERLOTINIB HCL 150 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
ERLOTINIB HCL 25 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in WV cover ERLOTINIB HCL 25 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
Errin 0.35 mg tablet ![Compare how all Medicare Part D PDP plans in WV cover Errin 0.35 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ERTAPENEM 1 GRAM VIAL [Invanz] ![Compare how all Medicare Part D PDP plans in WV cover ERTAPENEM 1 GRAM VIAL [Invanz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in WV cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ERYTHROCIN 500MG ADDVNT VL ![Compare how all Medicare Part D PDP plans in WV cover ERYTHROCIN 500MG ADDVNT VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ERYTHROMYCIN 0.5% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover ERYTHROMYCIN 0.5% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $0.00 | None |
ERYTHROMYCIN 2% SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover ERYTHROMYCIN 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $0.00 | None |
ERYTHROMYCIN EC 250 MG CAP ![Compare how all Medicare Part D PDP plans in WV cover ERYTHROMYCIN EC 250 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESBRIET 267 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ESBRIET 267 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:270 /30Days |
ESBRIET 267 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ESBRIET 267 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:270 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESBRIET 801 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ESBRIET 801 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in WV cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:45 /30Days |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in WV cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in WV cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro] ![Compare how all Medicare Part D PDP plans in WV cover ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:600 /30Days |
ESOMEPRAZOLE MAG DR 20 MG CAP [Nexium] ![Compare how all Medicare Part D PDP plans in WV cover ESOMEPRAZOLE MAG DR 20 MG CAP [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
ESOMEPRAZOLE MAG DR 40 MG CAP [Nexium] ![Compare how all Medicare Part D PDP plans in WV cover ESOMEPRAZOLE MAG DR 40 MG CAP [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C ![Compare how all Medicare Part D PDP plans in WV cover Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ESTRADIOL 0.01% CREAM ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
Estradiol 0.025 mg patch ![Compare how all Medicare Part D PDP plans in WV cover Estradiol 0.025 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:8 /28Days |
Estradiol 0.0375 mg patch ![Compare how all Medicare Part D PDP plans in WV cover Estradiol 0.0375 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:8 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Estradiol 0.05 mg patch ![Compare how all Medicare Part D PDP plans in WV cover Estradiol 0.05 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:8 /28Days |
Estradiol 0.075 mg patch ![Compare how all Medicare Part D PDP plans in WV cover Estradiol 0.075 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:8 /28Days |
Estradiol 0.1 mg patch ![Compare how all Medicare Part D PDP plans in WV cover Estradiol 0.1 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:8 /28Days |
ESTRADIOL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESTRADIOL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESTRADIOL 10 MCG VAGINAL INSRT ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL 10 MCG VAGINAL INSRT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESTRADIOL TDS 0.025 MG/DAY ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL TDS 0.025 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:4 /28Days |
ESTRADIOL TDS 0.0375 MG/DAY ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL TDS 0.0375 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:4 /28Days |
ESTRADIOL TDS 0.05 MG/DAY ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL TDS 0.05 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:4 /28Days |
ESTRADIOL TDS 0.06 MG/DAY ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL TDS 0.06 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL TDS 0.075 MG/DAY ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL TDS 0.075 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:4 /28Days |
ESTRADIOL TDS 0.1 MG/DAY ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL TDS 0.1 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:4 /28Days |
ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in WV cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:1 /90Days |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in WV cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6 ![Compare how all Medicare Part D PDP plans in WV cover ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21 ![Compare how all Medicare Part D PDP plans in WV cover ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETHOSUXIMIDE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover ETHOSUXIMIDE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETHOSUXIMIDE 250 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in WV cover ETHOSUXIMIDE 250 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in WV cover ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ethynodiol-eth estra 1mg-50mcg [ZOVIA] ![Compare how all Medicare Part D PDP plans in WV cover ethynodiol-eth estra 1mg-50mcg [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETIDRONATE DISODIUM 400MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in WV cover ETIDRONATE DISODIUM 400MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETIDRONATE DISODIUM TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in WV cover ETIDRONATE DISODIUM TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETODOLAC 200 MG CAPSULE [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC 200 MG CAPSULE [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ETODOLAC 300 MG CAPSULE [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC 300 MG CAPSULE [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ETODOLAC 400 MG TABLET [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC 400 MG TABLET [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ETODOLAC 500 MG TABLET [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC 500 MG TABLET [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ETODOLAC ER 400 MG TABLET [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC ER 400 MG TABLET [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ETODOLAC ER 500 MG TABLET [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC ER 500 MG TABLET [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETODOLAC ER 600 MG TABLET [LODINE] ![Compare how all Medicare Part D PDP plans in WV cover ETODOLAC ER 600 MG TABLET [LODINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
EVOTAZ 300 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EVOTAZ 300 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
EXEMESTANE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EXEMESTANE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:60 /30Days |
EXJADE 125MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EXJADE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
EXJADE 250MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EXJADE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
EXJADE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover EXJADE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
EZETIMIBE 10 MG TABLET [Zetia] ![Compare how all Medicare Part D PDP plans in WV cover EZETIMIBE 10 MG TABLET [Zetia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
Ezetimibe-Simvastatin 10-10 MG [Vytorin] ![Compare how all Medicare Part D PDP plans in WV cover Ezetimibe-Simvastatin 10-10 MG [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
Ezetimibe-Simvastatin 10-20 MG [Vytorin] ![Compare how all Medicare Part D PDP plans in WV cover Ezetimibe-Simvastatin 10-20 MG [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
Ezetimibe-Simvastatin 10-40 MG [Vytorin] ![Compare how all Medicare Part D PDP plans in WV cover Ezetimibe-Simvastatin 10-40 MG [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
Ezetimibe-Simvastatin 10-80 MG [Vytorin] ![Compare how all Medicare Part D PDP plans in WV cover Ezetimibe-Simvastatin 10-80 MG [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |