2019 Medicare Part D Plan Formulary Information |
Express Scripts Medicare - Choice (PDP) (S5660-206-0)
Benefit Details
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The Express Scripts Medicare - Choice (PDP) (S5660-206-0) Formulary Drugs Starting with the Letter S in CMS PDP Region 2 which includes: CT MA RI VT Plan Monthly Premium: $94.80 Deductible: $350 Qualifies for LIS: No |
Drugs Starting with Letter S
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
SANDIMMUNE 100MG/ML TUBEX ![Compare how all Medicare Part D PDP plans in VT cover SANDIMMUNE 100MG/ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | P |
SANTYL OINTMENT ![Compare how all Medicare Part D PDP plans in VT cover SANTYL OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SAPHRIS 10 MG TAB SL BLK CHERY ![Compare how all Medicare Part D PDP plans in VT cover SAPHRIS 10 MG TAB SL BLK CHERY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P Q:60 /30Days |
SAPHRIS 2.5 MG TAB SL BLK CHRY ![Compare how all Medicare Part D PDP plans in VT cover SAPHRIS 2.5 MG TAB SL BLK CHRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P Q:60 /30Days |
SAPHRIS 5 MG TAB SL BLK CHERRY ![Compare how all Medicare Part D PDP plans in VT cover SAPHRIS 5 MG TAB SL BLK CHERRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P Q:60 /30Days |
SAVELLA TABLETS 100MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in VT cover SAVELLA TABLETS 100MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SAVELLA TABLETS 12.5MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in VT cover SAVELLA TABLETS 12.5MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SAVELLA TABLETS 25MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in VT cover SAVELLA TABLETS 25MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM ![Compare how all Medicare Part D PDP plans in VT cover SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:55 /30Days |
SAVELLA TALBETS 50MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in VT cover SAVELLA TALBETS 50MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SCOPOLAMINE 1 MG/3 DAY PATCH [Transderm Scop] ![Compare how all Medicare Part D PDP plans in VT cover SCOPOLAMINE 1 MG/3 DAY PATCH [Transderm Scop].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:10 /30Days |
SEGLUROMET 2.5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SEGLUROMET 2.5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:60 /30Days |
SEGLUROMET 2.5-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SEGLUROMET 2.5-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:120 /30Days |
SEGLUROMET 7.5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SEGLUROMET 7.5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:60 /30Days |
SEGLUROMET 7.5-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SEGLUROMET 7.5-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:60 /30Days |
SELEGILINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SELEGILINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SELEGILINE HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover SELEGILINE HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:60 /30Days |
SELZENTRY 20 MG/ML ORAL SOLN ![Compare how all Medicare Part D PDP plans in VT cover SELZENTRY 20 MG/ML ORAL SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SELZENTRY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SELZENTRY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:120 /30Days |
SELZENTRY 75 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SELZENTRY 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:60 /30Days |
SENSIPAR 30MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SENSIPAR 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SENSIPAR 60MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SENSIPAR 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:60 /30Days |
SENSIPAR 90MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SENSIPAR 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:120 /30Days |
SEREVENT DIS AER 50MCG ![Compare how all Medicare Part D PDP plans in VT cover SEREVENT DIS AER 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SERTRALINE 20 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in VT cover SERTRALINE 20 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SERTRALINE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SERTRALINE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:60 /30Days |
SERTRALINE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SERTRALINE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
SERTRALINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SERTRALINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:60 /30Days |
SETLAKIN 0.15 MG-0.03 MG TAB ![Compare how all Medicare Part D PDP plans in VT cover SETLAKIN 0.15 MG-0.03 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SEVELAMER 0.8 GM POWDER PACKET [RENVELA] ![Compare how all Medicare Part D PDP plans in VT cover SEVELAMER 0.8 GM POWDER PACKET [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | None |
SEVELAMER 2.4 GM POWDER PACKET POWD PACK [Renvela] ![Compare how all Medicare Part D PDP plans in VT cover SEVELAMER 2.4 GM POWDER PACKET POWD PACK [Renvela].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | None |
SEVELAMER CARBONATE 800 MG TAB [RENVELA] ![Compare how all Medicare Part D PDP plans in VT cover SEVELAMER CARBONATE 800 MG TAB [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:540 /30Days |
SEVELAMER HCL 400 MG TABLET [RenaGel] ![Compare how all Medicare Part D PDP plans in VT cover SEVELAMER HCL 400 MG TABLET [RenaGel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SEVELAMER HCL 800 MG TABLET [RenaGel] ![Compare how all Medicare Part D PDP plans in VT cover SEVELAMER HCL 800 MG TABLET [RenaGel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SHAROBEL 0.35 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SHAROBEL 0.35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SHINGRIX VIAL KIT ![Compare how all Medicare Part D PDP plans in VT cover SHINGRIX VIAL KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
Signifor .3 mg/mL ![Compare how all Medicare Part D PDP plans in VT cover Signifor .3 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
Signifor .6 mg/mL ![Compare how all Medicare Part D PDP plans in VT cover Signifor .6 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
Signifor .9 mg/mL ![Compare how all Medicare Part D PDP plans in VT cover Signifor .9 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SILDENAFIL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SILDENAFIL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | P Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SILVER SULFADIAZINE 1% CREAM ![Compare how all Medicare Part D PDP plans in VT cover SILVER SULFADIAZINE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SIMBRINZA 1%-0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in VT cover SIMBRINZA 1%-0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SIMVASTATIN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SIMVASTATIN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SIMVASTATIN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 40 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SIMVASTATIN 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 5 MG TABLET [Zocor] ![Compare how all Medicare Part D PDP plans in VT cover SIMVASTATIN 5 MG TABLET [Zocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
SIMVASTATIN 80 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SIMVASTATIN 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
Sirolimus 0.5 MG Tablet [Rapamune] ![Compare how all Medicare Part D PDP plans in VT cover Sirolimus 0.5 MG Tablet [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | P |
SIROLIMUS 1 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in VT cover SIROLIMUS 1 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | P |
SIROLIMUS 1 MG/ML SOLUTION [Rapamune] ![Compare how all Medicare Part D PDP plans in VT cover SIROLIMUS 1 MG/ML SOLUTION [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SIROLIMUS 2 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in VT cover SIROLIMUS 2 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIRTURO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SIRTURO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SKLICE 0.5% LOTION ![Compare how all Medicare Part D PDP plans in VT cover SKLICE 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SKYRIZI 150 MG DOSE KIT-2 SYRINGEKIT ![Compare how all Medicare Part D PDP plans in VT cover SKYRIZI 150 MG DOSE KIT-2 SYRINGEKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:1 /28Days |
SODIUM CHLORIDE 0.45% TUBEX ![Compare how all Medicare Part D PDP plans in VT cover SODIUM CHLORIDE 0.45% TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SODIUM CHLORIDE 0.9% IRRIG. ![Compare how all Medicare Part D PDP plans in VT cover SODIUM CHLORIDE 0.9% IRRIG..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SODIUM CHLORIDE 0.9% IV SOLN ![Compare how all Medicare Part D PDP plans in VT cover SODIUM CHLORIDE 0.9% IV SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
Sodium Chloride 3g/100mL ![Compare how all Medicare Part D PDP plans in VT cover Sodium Chloride 3g/100mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SODIUM CHLORIDE INJECTION USP 5% ![Compare how all Medicare Part D PDP plans in VT cover SODIUM CHLORIDE INJECTION USP 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SODIUM POLYSTYRENE SULF POWDER ![Compare how all Medicare Part D PDP plans in VT cover SODIUM POLYSTYRENE SULF POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOLIFENACIN 10 MG TABLET [VESIcare] ![Compare how all Medicare Part D PDP plans in VT cover SOLIFENACIN 10 MG TABLET [VESIcare].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SOLIFENACIN 5 MG TABLET [VESIcare] ![Compare how all Medicare Part D PDP plans in VT cover SOLIFENACIN 5 MG TABLET [VESIcare].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SOLTAMOX 20 MG/10 ML SOLN Solution ![Compare how all Medicare Part D PDP plans in VT cover SOLTAMOX 20 MG/10 ML SOLN Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SOMATULINE DEPOT 120 MG/0.5 ML ![Compare how all Medicare Part D PDP plans in VT cover SOMATULINE DEPOT 120 MG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SOMATULINE DEPOT 60 MG/0.2 ML ![Compare how all Medicare Part D PDP plans in VT cover SOMATULINE DEPOT 60 MG/0.2 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SOMATULINE DEPOT 90 MG/0.3 ML ![Compare how all Medicare Part D PDP plans in VT cover SOMATULINE DEPOT 90 MG/0.3 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SOMAVERT 10 MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover SOMAVERT 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SOMAVERT 15 MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover SOMAVERT 15 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SOMAVERT 20 MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover SOMAVERT 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SOMAVERT 25 MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover SOMAVERT 25 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SOMAVERT 30 MG VIAL ![Compare how all Medicare Part D PDP plans in VT cover SOMAVERT 30 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in VT cover SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in VT cover SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in VT cover SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in VT cover SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOTALOL 120 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in VT cover SOTALOL 120 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOTALOL 160 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in VT cover SOTALOL 160 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOTALOL 240 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in VT cover SOTALOL 240 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOTALOL 80 MG TABLET [Sorine] ![Compare how all Medicare Part D PDP plans in VT cover SOTALOL 80 MG TABLET [Sorine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOTALOL AF 120 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SOTALOL AF 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SOTYLIZE 5 MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover SOTYLIZE 5 MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SOVALDI 400 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SOVALDI 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:28 /28Days |
SPIRIVA 18 MCG CP-HANDIHALER ![Compare how all Medicare Part D PDP plans in VT cover SPIRIVA 18 MCG CP-HANDIHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:90 /90Days |
SPIRIVA RESPIMAT 1.25 MCG INH ![Compare how all Medicare Part D PDP plans in VT cover SPIRIVA RESPIMAT 1.25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:4 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPIRIVA RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in VT cover SPIRIVA RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:4 /30Days |
SPIRONOLACTONE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPIRONOLACTONE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SPIRONOLACTONE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPIRONOLACTONE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
SPIRONOLACTONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPIRONOLACTONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SPIRONOLACTONE-HCTZ 25-25 TAB ![Compare how all Medicare Part D PDP plans in VT cover SPIRONOLACTONE-HCTZ 25-25 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SPORANOX 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VT cover SPORANOX 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | None |
SPRINTEC 0.25-0.035 TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRINTEC 0.25-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SPRITAM 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRITAM 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SPRITAM 250 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRITAM 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SPRITAM 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRITAM 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SPRITAM 750 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRITAM 750 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SPRYCEL 20MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRYCEL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:90 /30Days |
SPRYCEL 50MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRYCEL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SPRYCEL 70MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SPRYCEL 70MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:60 /30Days |
SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SPS 15 GM/60 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in VT cover SPS 15 GM/60 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SRONYX 0.10-0.02 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SRONYX 0.10-0.02 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SSD 1% CREAM ![Compare how all Medicare Part D PDP plans in VT cover SSD 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
STAVUDINE 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover STAVUDINE 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:60 /30Days |
STAVUDINE 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover STAVUDINE 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
STAVUDINE CAPSULES 30MG 60 BOT ![Compare how all Medicare Part D PDP plans in VT cover STAVUDINE CAPSULES 30MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:60 /30Days |
STAVUDINE CAPSULES 40MG 60 BOT ![Compare how all Medicare Part D PDP plans in VT cover STAVUDINE CAPSULES 40MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:60 /30Days |
STEGLATRO 15 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover STEGLATRO 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:30 /30Days |
STEGLATRO 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover STEGLATRO 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:30 /30Days |
Stimate 1.5mg/mL 1 BOTTLE, SPRAY per CARTON / 2.5 mL in 1 BOTTLE, SPRAY ![Compare how all Medicare Part D PDP plans in VT cover Stimate 1.5mg/mL 1 BOTTLE, SPRAY per CARTON / 2.5 mL in 1 BOTTLE, SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | None |
STIOLTO RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in VT cover STIOLTO RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:4 /30Days |
STIVARGA 40 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover STIVARGA 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:84 /28Days |
STREPTOMYCIN FOR INJECTION 1GM/VIL ![Compare how all Medicare Part D PDP plans in VT cover STREPTOMYCIN FOR INJECTION 1GM/VIL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
STRIBILD TABLET ![Compare how all Medicare Part D PDP plans in VT cover STRIBILD TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:30 /30Days |
SUBOXONE 12 MG-3 MG SL FILM ![Compare how all Medicare Part D PDP plans in VT cover SUBOXONE 12 MG-3 MG SL FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
Suboxone 2; 0.5mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH ![Compare how all Medicare Part D PDP plans in VT cover Suboxone 2; 0.5mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUBOXONE 4 MG-1 MG SL FILM ![Compare how all Medicare Part D PDP plans in VT cover SUBOXONE 4 MG-1 MG SL FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:90 /30Days |
Suboxone 8; 2mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH ![Compare how all Medicare Part D PDP plans in VT cover Suboxone 8; 2mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:90 /30Days |
SUCRAID 8500[iU]/mL ![Compare how all Medicare Part D PDP plans in VT cover SUCRAID 8500[iU]/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | None |
SUCRALFATE 1GM TABLET ![Compare how all Medicare Part D PDP plans in VT cover SUCRALFATE 1GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULF-PRED 10-0.23% EYE DROPS ![Compare how all Medicare Part D PDP plans in VT cover SULF-PRED 10-0.23% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULFACETAMIDE 10% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in VT cover SULFACETAMIDE 10% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULFACETAMIDE SOD 10% TOP SUSP ![Compare how all Medicare Part D PDP plans in VT cover SULFACETAMIDE SOD 10% TOP SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT ![Compare how all Medicare Part D PDP plans in VT cover SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
Sulfadiazine 500mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover Sulfadiazine 500mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SULFAMETHOXAZOLE-TMP DS TABLET [Septra DS] ![Compare how all Medicare Part D PDP plans in VT cover SULFAMETHOXAZOLE-TMP DS TABLET [Septra DS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULFAMETHOXAZOLE-TMP SS TABLET [Septra] ![Compare how all Medicare Part D PDP plans in VT cover SULFAMETHOXAZOLE-TMP SS TABLET [Septra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SULFAMETHOXAZOLE-TMP SUSP Oral Suspension [Sultrex Pediatric] ![Compare how all Medicare Part D PDP plans in VT cover SULFAMETHOXAZOLE-TMP SUSP Oral Suspension [Sultrex Pediatric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULFAMYLON 8.5% CREAM ![Compare how all Medicare Part D PDP plans in VT cover SULFAMYLON 8.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SULFASALAZINE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SULFASALAZINE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULFASALAZINE DR 500 MG TAB ![Compare how all Medicare Part D PDP plans in VT cover SULFASALAZINE DR 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULINDAC 150 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SULINDAC 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SULINDAC 200 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SULINDAC 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
Sumatriptan 20 MG/ACTUAT Nasal Spray ![Compare how all Medicare Part D PDP plans in VT cover Sumatriptan 20 MG/ACTUAT Nasal Spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:18 /28Days |
SUMATRIPTAN 4 MG/0.5 ML CART ![Compare how all Medicare Part D PDP plans in VT cover SUMATRIPTAN 4 MG/0.5 ML CART.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:8 /28Days |
Sumatriptan 4 mg/0.5 ml inject ![Compare how all Medicare Part D PDP plans in VT cover Sumatriptan 4 mg/0.5 ml inject.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:8 /28Days |
Sumatriptan 5 MG/ACTUAT Nasal Spray ![Compare how all Medicare Part D PDP plans in VT cover Sumatriptan 5 MG/ACTUAT Nasal Spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | Q:36 /28Days |
SUMATRIPTAN 6 MG/0.5 ML INJECT ![Compare how all Medicare Part D PDP plans in VT cover SUMATRIPTAN 6 MG/0.5 ML INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:8 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUMATRIPTAN 6 MG/0.5 ML INJECT ![Compare how all Medicare Part D PDP plans in VT cover SUMATRIPTAN 6 MG/0.5 ML INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:8 /28Days |
SUMATRIPTAN 6 MG/0.5 ML SYRNG Syringe [Sumavel DosePro System] ![Compare how all Medicare Part D PDP plans in VT cover SUMATRIPTAN 6 MG/0.5 ML SYRNG Syringe [Sumavel DosePro System].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:8 /28Days |
Sumatriptan 6 mg/0.5 ml vial ![Compare how all Medicare Part D PDP plans in VT cover Sumatriptan 6 mg/0.5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:8 /28Days |
SUMATRIPTAN SUCC 100 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SUMATRIPTAN SUCC 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:18 /28Days |
SUMATRIPTAN SUCC 50 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SUMATRIPTAN SUCC 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:18 /28Days |
Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VT cover Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | Q:18 /28Days |
SUPRAX 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover SUPRAX 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SUPRAX 500 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in VT cover SUPRAX 500 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SUPREP BOWEL PREP KIT SOLN RECON ![Compare how all Medicare Part D PDP plans in VT cover SUPREP BOWEL PREP KIT SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
SUTENT 12.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover SUTENT 12.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SUTENT 25mg/1 28 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VT cover SUTENT 25mg/1 28 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUTENT 37.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover SUTENT 37.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SUTENT 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in VT cover SUTENT 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
SYEDA 28 TABLET [Zarah] ![Compare how all Medicare Part D PDP plans in VT cover SYEDA 28 TABLET [Zarah].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$7.00 | $4.00 | None |
SYLATRON 200 MCG KIT ![Compare how all Medicare Part D PDP plans in VT cover SYLATRON 200 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SYLATRON 300 MCG KIT ![Compare how all Medicare Part D PDP plans in VT cover SYLATRON 300 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SYLATRON 600 MCG KIT ![Compare how all Medicare Part D PDP plans in VT cover SYLATRON 600 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in VT cover SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:10 /30Days |
SYMBICORT 80; 4.5ug/1; ug/1 1 POUCH in 1 CARTON / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER ![Compare how all Medicare Part D PDP plans in VT cover SYMBICORT 80; 4.5ug/1; ug/1 1 POUCH in 1 CARTON / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:10 /30Days |
SYMDEKO 100/150 MG-150 MG TABS ![Compare how all Medicare Part D PDP plans in VT cover SYMDEKO 100/150 MG-150 MG TABS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:56 /28Days |
SYMFI 600-300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SYMFI 600-300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SYMFI LO 400-300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SYMFI LO 400-300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYMLINPEN 120 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in VT cover SYMLINPEN 120 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:11 /30Days |
SYMLINPEN 60 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in VT cover SYMLINPEN 60 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:6 /30Days |
SYMPAZAN 10 MG FILM ![Compare how all Medicare Part D PDP plans in VT cover SYMPAZAN 10 MG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P Q:60 /30Days |
SYMPAZAN 20 MG FILM ![Compare how all Medicare Part D PDP plans in VT cover SYMPAZAN 20 MG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P Q:60 /30Days |
SYMPAZAN 5 MG FILM ![Compare how all Medicare Part D PDP plans in VT cover SYMPAZAN 5 MG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P Q:60 /30Days |
SYMTUZA 800-150-200-10 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SYMTUZA 800-150-200-10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SYNAREL 2MG/ML NASAL SPRAY ![Compare how all Medicare Part D PDP plans in VT cover SYNAREL 2MG/ML NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
SYNJARDY 12.5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY 12.5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SYNJARDY 12.5-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY 12.5-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SYNJARDY 5-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY 5-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SYNJARDY XR 10-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY XR 10-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYNJARDY XR 12.5-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY XR 12.5-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SYNJARDY XR 25-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY XR 25-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
SYNJARDY XR 5-1,000 MG TABLET BP 24H ![Compare how all Medicare Part D PDP plans in VT cover SYNJARDY XR 5-1,000 MG TABLET BP 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
SYNRIBO 3.5 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VT cover SYNRIBO 3.5 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P |