2020 Medicare Part D Plan Formulary Information |
Kaiser Permanente Senior Advantage Hawaii Island (HMO) (H1230-014-0)
Benefit Details
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The Kaiser Permanente Senior Advantage Hawaii Island (HMO) (H1230-014-0) Formulary Drugs Starting with the Letter F in Hawaii County, HI: CMS MA Region 25 which includes: HI Plan Monthly Premium: $196.00 Deductible: $255 |
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FABIOR 0.1% FOAM ![Compare how all Medicare Part D PDP plans in HI cover FABIOR 0.1% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
FALMINA-28 TABLET ![Compare how all Medicare Part D PDP plans in HI cover FALMINA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FAMCICLOVIR 125 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FAMCICLOVIR 125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FAMCICLOVIR 250 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FAMCICLOVIR 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FAMCICLOVIR 500 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FAMCICLOVIR 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FAMOTIDINE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FAMOTIDINE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FAMOTIDINE 40 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FAMOTIDINE 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in HI cover FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FANAPT 1 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FANAPT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 12 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FANAPT 2 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FANAPT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FANAPT 6 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FANAPT 8 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FANAPT 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FANAPT TITR TABLETS ![Compare how all Medicare Part D PDP plans in HI cover FANAPT TITR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FARESTON 60 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FARESTON 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FARXIGA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FARXIGA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FARXIGA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FARXIGA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FARYDAK 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FARYDAK 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FARYDAK 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FARYDAK 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FASENRA 30 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FASENRA 30 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FASENRA PEN 30 MG/ML AUTO INJCT ![Compare how all Medicare Part D PDP plans in HI cover FASENRA PEN 30 MG/ML AUTO INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FAYOSIM TABLET TBDSPK 3MO [Quartette] ![Compare how all Medicare Part D PDP plans in HI cover FAYOSIM TABLET TBDSPK 3MO [Quartette].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FEBUXOSTAT 40 MG TABLET [Uloric] ![Compare how all Medicare Part D PDP plans in HI cover FEBUXOSTAT 40 MG TABLET [Uloric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FEBUXOSTAT 80 MG TABLET [Uloric] ![Compare how all Medicare Part D PDP plans in HI cover FEBUXOSTAT 80 MG TABLET [Uloric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FELBAMATE 600 MG TABLET [Felbatol] ![Compare how all Medicare Part D PDP plans in HI cover FELBAMATE 600 MG TABLET [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol] ![Compare how all Medicare Part D PDP plans in HI cover FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FELBATOL 400MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FELBATOL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FELBATOL 600 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in HI cover FELBATOL 600 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FELBATOL 600MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FELBATOL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELODIPINE ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FELODIPINE ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil] ![Compare how all Medicare Part D PDP plans in HI cover FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FELODIPINE ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FELODIPINE ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FEMRING 0.05 MG/DAY VAGINAL RING ![Compare how all Medicare Part D PDP plans in HI cover FEMRING 0.05 MG/DAY VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FEMRING 0.10 MG/DAY VAGINAL RING ![Compare how all Medicare Part D PDP plans in HI cover FEMRING 0.10 MG/DAY VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FEMYNOR 28 TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in HI cover FEMYNOR 28 TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 120 MG TABLET [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 120 MG TABLET [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 130 MG CAPSULE [Antara] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 130 MG CAPSULE [Antara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 134MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 134MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 145 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 145 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 150 MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 150 MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOFIBRATE 160 MG TABLET [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 160 MG TABLET [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 200 MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 200 MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 40 MG TABLET [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 40 MG TABLET [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 43 MG CAPSULE [Antara] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 43 MG CAPSULE [Antara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 48 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 48 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 50 MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 50 MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 54 MG 90 TABLET BOTTLE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 54 MG 90 TABLET BOTTLE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRATE 67MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRATE 67MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRIC ACID DR 135 MG CAPSULE [TRILIPIX] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRIC ACID DR 135 MG CAPSULE [TRILIPIX].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOFIBRIC ACID DR 45 MG CAPSULE DR [Trilipix] ![Compare how all Medicare Part D PDP plans in HI cover FENOFIBRIC ACID DR 45 MG CAPSULE DR [Trilipix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENOPROFEN 600 MG TABLET [ProFeno] ![Compare how all Medicare Part D PDP plans in HI cover FENOPROFEN 600 MG TABLET [ProFeno].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOPROFEN CALCIUM 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FENOPROFEN CALCIUM 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 100 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 100 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 12 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 12 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 25 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 25 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 37.5 MCG/HR PATCH TD72 ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 37.5 MCG/HR PATCH TD72.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 50 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 50 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 62.5 MCG/HR PATCH TD72 ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 62.5 MCG/HR PATCH TD72.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 75 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 75 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL 87.5 MCG/HR PATCH TD72 ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL 87.5 MCG/HR PATCH TD72.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FENTANYL CIT 100 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT 100 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
FENTANYL CIT 200 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT 200 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL CIT 400 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT 400 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
FENTANYL CIT 600 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT 600 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
FENTANYL CIT 800 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT 800 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in HI cover FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
FENTORA TABLET 100MCG ![Compare how all Medicare Part D PDP plans in HI cover FENTORA TABLET 100MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
FENTORA TABLET 200MCG ![Compare how all Medicare Part D PDP plans in HI cover FENTORA TABLET 200MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTORA TABLET 400MCG ![Compare how all Medicare Part D PDP plans in HI cover FENTORA TABLET 400MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
FENTORA TABLET 600MCG ![Compare how all Medicare Part D PDP plans in HI cover FENTORA TABLET 600MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
FENTORA TABLET 800MCG ![Compare how all Medicare Part D PDP plans in HI cover FENTORA TABLET 800MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
FERRIPROX 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FERRIPROX 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FERRIPROX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in HI cover FERRIPROX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FERRIPROX 500 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FERRIPROX 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FETZIMA 20-40 MG TITRATION PAK ![Compare how all Medicare Part D PDP plans in HI cover FETZIMA 20-40 MG TITRATION PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FETZIMA ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FETZIMA ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FETZIMA ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FETZIMA ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FETZIMA ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FETZIMA ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FETZIMA ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FETZIMA ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FEXMID 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FEXMID 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN ![Compare how all Medicare Part D PDP plans in HI cover FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FIASP 100 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover FIASP 100 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FINACEA 15% FOAM ![Compare how all Medicare Part D PDP plans in HI cover FINACEA 15% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FINASTERIDE 5 MG TABLET [Proscar] ![Compare how all Medicare Part D PDP plans in HI cover FINASTERIDE 5 MG TABLET [Proscar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FIORICET 50-300-40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FIORICET 50-300-40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Fioricet/Codeine 50-300-40-30 CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover Fioricet/Codeine 50-300-40-30 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FIRAZYR 30 MG/3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FIRAZYR 30 MG/3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FIRDAPSE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FIRDAPSE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FIRMAGON 2 X 120 MG KIT ![Compare how all Medicare Part D PDP plans in HI cover FIRMAGON 2 X 120 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FIRMAGON 80 MG KIT ![Compare how all Medicare Part D PDP plans in HI cover FIRMAGON 80 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FIRVANQ 25 MG/ML SOLUTION SOLN RECON ![Compare how all Medicare Part D PDP plans in HI cover FIRVANQ 25 MG/ML SOLUTION SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FIRVANQ 50 MG/ML SOLUTION RECON ![Compare how all Medicare Part D PDP plans in HI cover FIRVANQ 50 MG/ML SOLUTION RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLAC OTIC OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in HI cover FLAC OTIC OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLAREX 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover FLAREX 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLAVOXATE 100 MG TABLET 100 ![Compare how all Medicare Part D PDP plans in HI cover FLAVOXATE 100 MG TABLET 100.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLEBOGAMMA DIF INJECTION ![Compare how all Medicare Part D PDP plans in HI cover FLEBOGAMMA DIF INJECTION .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
FLECAINIDE ACETATE 100 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in HI cover FLECAINIDE ACETATE 100 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLECAINIDE ACETATE 150 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in HI cover FLECAINIDE ACETATE 150 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLECAINIDE ACETATE 50 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in HI cover FLECAINIDE ACETATE 50 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLECTOR 1.3% PATCH TD12 ![Compare how all Medicare Part D PDP plans in HI cover FLECTOR 1.3% PATCH TD12.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | P |
FLOLIPID 20 MG/5 ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in HI cover FLOLIPID 20 MG/5 ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOLIPID 40 MG/5 ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in HI cover FLOLIPID 40 MG/5 ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in HI cover FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in HI cover FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in HI cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in HI cover FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in HI cover FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in HI cover FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCONAZOLE 100 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE 100 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCONAZOLE 150 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE 150 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCONAZOLE 200 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE 200 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCONAZOLE 50 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE 50 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in HI cover FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUCYTOSINE 250 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in HI cover FLUCYTOSINE 250 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FLUCYTOSINE 500 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in HI cover FLUCYTOSINE 500 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FLUDROCORTISONE 0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FLUDROCORTISONE 0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in HI cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINOLONE 0.01% CREAM (g) ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINOLONE 0.01% CREAM (g).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINOLONE 0.01% SCALP OIL [Derma-Smoothe/FS] ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINOLONE 0.01% SCALP OIL [Derma-Smoothe/FS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINOLONE 0.01% SOLUTION [Synalar] ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINOLONE 0.01% SOLUTION [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINOLONE 0.025% CREAM (g) [Synalar] ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINOLONE 0.025% CREAM (g) [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINOLONE 0.025% OINTMENT ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINOLONE 0.025% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINOLONE OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINOLONE OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINONIDE 0.05% GEL ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINONIDE 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINONIDE 0.05% OINTMENT [Lidex] ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINONIDE 0.05% OINTMENT [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINONIDE 0.1% CREAM (g) [Vanos] ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINONIDE 0.1% CREAM (g) [Vanos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOCINONIDE-E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in HI cover FLUOCINONIDE-E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Fluorometholone 0.1% drops ![Compare how all Medicare Part D PDP plans in HI cover Fluorometholone 0.1% drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOROURACIL 0.5% CREAM ![Compare how all Medicare Part D PDP plans in HI cover FLUOROURACIL 0.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FLUOROURACIL 2% TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in HI cover FLUOROURACIL 2% TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOROURACIL 5% CREAM (g) [Efudex] ![Compare how all Medicare Part D PDP plans in HI cover FLUOROURACIL 5% CREAM (g) [Efudex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOROURACIL 5% TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in HI cover FLUOROURACIL 5% TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in HI cover Fluoxetine 20mg/5mL 120 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOXETINE DR 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE DR 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOXETINE HCL 10 MG CAPSULE [Selfemra] ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE HCL 10 MG CAPSULE [Selfemra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $4.00 | None |
FLUOXETINE HCL 10 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE HCL 10 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOXETINE HCL 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE HCL 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $4.00 | None |
FLUOXETINE HCL 20 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE HCL 20 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUOXETINE HCL 40 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE HCL 40 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $4.00 | None |
FLUOXETINE HCL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FLUOXETINE HCL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 10 MG TABLET [Prolixin] ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 10 MG TABLET [Prolixin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE 2.5 MG/5 ML ELIX ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 2.5 MG/5 ML ELIX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate] ![Compare how all Medicare Part D PDP plans in HI cover FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Flurandrenolide 0.05% Cream [Cordran] ![Compare how all Medicare Part D PDP plans in HI cover Flurandrenolide 0.05% Cream [Cordran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Flurandrenolide 0.05% ointment [Cordran] ![Compare how all Medicare Part D PDP plans in HI cover Flurandrenolide 0.05% ointment [Cordran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Flurandrenolide 0.5 MG/ML Topical Lotion [Cordran] ![Compare how all Medicare Part D PDP plans in HI cover Flurandrenolide 0.5 MG/ML Topical Lotion [Cordran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Flurazepam Hydrochloride 15mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in HI cover Flurazepam Hydrochloride 15mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Flurazepam Hydrochloride 30mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in HI cover Flurazepam Hydrochloride 30mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLURBIPROFEN 0.03% EYE DROPS [Ocufen] ![Compare how all Medicare Part D PDP plans in HI cover FLURBIPROFEN 0.03% EYE DROPS [Ocufen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in HI cover Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTAMIDE 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FLUTAMIDE 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE PROP 0.005% OINTMENT [Cutivate] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE PROP 0.005% OINTMENT [Cutivate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE PROP 0.05% LOTION ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE PROP 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in HI cover Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE-SALMETEROL 100-50 BLST W/DEV [Advair] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE-SALMETEROL 100-50 BLST W/DEV [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUTICASONE-SALMETEROL 250-50 BLST W/DEV [Advair] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE-SALMETEROL 250-50 BLST W/DEV [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE-SALMETEROL 500-50 BLST W/DEV [Advair] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE-SALMETEROL 500-50 BLST W/DEV [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in HI cover FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVASTATIN ER 80 MG TABLET ER 24H [Lescol XL] ![Compare how all Medicare Part D PDP plans in HI cover FLUVASTATIN ER 80 MG TABLET ER 24H [Lescol XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in HI cover FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in HI cover FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVOXAMINE ER 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FLUVOXAMINE ER 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVOXAMINE ER 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in HI cover FLUVOXAMINE ER 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVOXAMINE MALEATE 100 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in HI cover FLUVOXAMINE MALEATE 100 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVOXAMINE MALEATE 25 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in HI cover FLUVOXAMINE MALEATE 25 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FLUVOXAMINE MALEATE 50 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in HI cover FLUVOXAMINE MALEATE 50 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FML FORTE 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in HI cover FML FORTE 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
FML S.O.P. 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in HI cover FML S.O.P. 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in HI cover FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FONDAPARINUX 2.5 MG/0.5 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in HI cover FONDAPARINUX 2.5 MG/0.5 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in HI cover FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in HI cover FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
Fondaparinux sodium 10 MG per 0.8 ML Prefilled Syringe [Arixtra] ![Compare how all Medicare Part D PDP plans in HI cover Fondaparinux sodium 10 MG per 0.8 ML Prefilled Syringe [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
Fondaparinux sodium 5 MG in 0.4 ML Prefilled Syringe [Arixtra] ![Compare how all Medicare Part D PDP plans in HI cover Fondaparinux sodium 5 MG in 0.4 ML Prefilled Syringe [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
FOSAMAX PLUS D 70; 5600mg/1; [iU]/1 4 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in HI cover FOSAMAX PLUS D 70; 5600mg/1; [iU]/1 4 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FOSAMAX PLUS D 70MG/2800 IU ![Compare how all Medicare Part D PDP plans in HI cover FOSAMAX PLUS D 70MG/2800 IU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSAMPRENAVIR 700 MG TABLET [Lexiva] ![Compare how all Medicare Part D PDP plans in HI cover FOSAMPRENAVIR 700 MG TABLET [Lexiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FOSINOPRIL SODIUM 10 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FOSINOPRIL SODIUM 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FOSINOPRIL SODIUM 20 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FOSINOPRIL SODIUM 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FOSINOPRIL SODIUM 40 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FOSINOPRIL SODIUM 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in HI cover FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in HI cover FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FOSRENOL 1,000 MG POWDER PACK ![Compare how all Medicare Part D PDP plans in HI cover FOSRENOL 1,000 MG POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FOSRENOL 750 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in HI cover FOSRENOL 750 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FRAGMIN 10,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 10,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FRAGMIN 12,500 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 12,500 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FRAGMIN 15,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 15,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FRAGMIN 18,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 18,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FRAGMIN 2,500 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 2,500 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FRAGMIN 5,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 5,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FRAGMIN 7,500 UNITS/0.3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 7,500 UNITS/0.3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FRAGMIN 95,000 UNITS/3.8 ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover FRAGMIN 95,000 UNITS/3.8 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FREAMINE HBC INJECTION ![Compare how all Medicare Part D PDP plans in HI cover FREAMINE HBC INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FROVATRIPTAN SUCC 2.5 MG TABLET [Frova] ![Compare how all Medicare Part D PDP plans in HI cover FROVATRIPTAN SUCC 2.5 MG TABLET [Frova].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FULPHILA 6 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in HI cover FULPHILA 6 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FUROSEMIDE 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in HI cover FUROSEMIDE 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FUROSEMIDE 100 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in HI cover FUROSEMIDE 100 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P ![Compare how all Medicare Part D PDP plans in HI cover Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FUROSEMIDE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FUROSEMIDE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $4.00 | None |
FUROSEMIDE 40 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in HI cover FUROSEMIDE 40 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $4.00 | None |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in HI cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FUROSEMIDE 80 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FUROSEMIDE 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $4.00 | None |
FUZEON 90 MG VIAL ![Compare how all Medicare Part D PDP plans in HI cover FUZEON 90 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
FYAVOLV 1 MG-5 MCG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYAVOLV 1 MG-5 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
FYCOMPA 0.5 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 0.5 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
FYCOMPA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FYCOMPA 12 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FYCOMPA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FYCOMPA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FYCOMPA 6 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |
FYCOMPA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in HI cover FYCOMPA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$100.00 | $200.00 | None |