2020 Medicare Part D Plan Formulary Information |
MVP WellSelect with Part D (PPO) (H9615-008-0)
Benefit Details
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The MVP WellSelect with Part D (PPO) (H9615-008-0) Formulary Drugs Starting with the Letter C in Greene County, NY: CMS MA Region 3 which includes: NY Plan Monthly Premium: $0.00 Deductible: $325 |
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CABERGOLINE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CABERGOLINE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CABLIVI 11 MG KIT ![Compare how all Medicare Part D PDP plans in NY cover CABLIVI 11 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
CABOMETYX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CABOMETYX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CABOMETYX 40 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CABOMETYX 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CABOMETYX 60 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CABOMETYX 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CALCIPOTRIENE 0.005% CREAM (g) [Dovonex] ![Compare how all Medicare Part D PDP plans in NY cover CALCIPOTRIENE 0.005% CREAM (g) [Dovonex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CALCIPOTRIENE 0.005% OINTMENT [Dovonex] ![Compare how all Medicare Part D PDP plans in NY cover CALCIPOTRIENE 0.005% OINTMENT [Dovonex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CALCIPOTRIENE 0.005% SOLUTION [Dovonex Scalp] ![Compare how all Medicare Part D PDP plans in NY cover CALCIPOTRIENE 0.005% SOLUTION [Dovonex Scalp].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CALCIPOTRIENE-BETAMETH DP OINTMENT [Taclonex] ![Compare how all Medicare Part D PDP plans in NY cover CALCIPOTRIENE-BETAMETH DP OINTMENT [Taclonex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CALCIPOTRIENE-BETAMETH DP SUSPENSION [Taclonex Scalp] ![Compare how all Medicare Part D PDP plans in NY cover CALCIPOTRIENE-BETAMETH DP SUSPENSION [Taclonex Scalp].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in NY cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CALCITRIOL 0.25 MCG CAPSULE [Rocaltrol] ![Compare how all Medicare Part D PDP plans in NY cover CALCITRIOL 0.25 MCG CAPSULE [Rocaltrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CALCITRIOL 0.5 MCG CAPSULE [Rocaltrol] ![Compare how all Medicare Part D PDP plans in NY cover CALCITRIOL 0.5 MCG CAPSULE [Rocaltrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CALCITRIOL 1 MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in NY cover CALCITRIOL 1 MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CALCITRIOL 3 MCG/G OINTMENT ![Compare how all Medicare Part D PDP plans in NY cover CALCITRIOL 3 MCG/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CALCIUM ACETATE 667 MG GELCAPSULE [PhosLo] ![Compare how all Medicare Part D PDP plans in NY cover CALCIUM ACETATE 667 MG GELCAPSULE [PhosLo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CALCIUM ACETATE 667 MG TABLET [PhosLo] ![Compare how all Medicare Part D PDP plans in NY cover CALCIUM ACETATE 667 MG TABLET [PhosLo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CALQUENCE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CALQUENCE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CAMILA 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in NY cover CAMILA 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CAMRESE LO TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAMRESE LO TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CANDESARTAN CILEXETIL 16 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN CILEXETIL 16 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CANDESARTAN CILEXETIL 32 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN CILEXETIL 32 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CANDESARTAN CILEXETIL 4 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN CILEXETIL 4 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CANDESARTAN CILEXETIL 8 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN CILEXETIL 8 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CANDESARTAN-HCTZ 16-12.5 MG TABLET [Atacand HCT] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN-HCTZ 16-12.5 MG TABLET [Atacand HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CANDESARTAN-HCTZ 32-12.5 MG TABLET [Atacand HCT] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN-HCTZ 32-12.5 MG TABLET [Atacand HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CANDESARTAN-HCTZ 32-25 MG TABLET [Atacand HCT] ![Compare how all Medicare Part D PDP plans in NY cover CANDESARTAN-HCTZ 32-25 MG TABLET [Atacand HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CAPLYTA 42 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CAPLYTA 42 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
CAPRELSA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAPRELSA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P Q:60 /30Days |
CAPRELSA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAPRELSA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P Q:30 /30Days |
CAPTOPRIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAPTOPRIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CAPTOPRIL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAPTOPRIL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAPTOPRIL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAPTOPRIL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CAPTOPRIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAPTOPRIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Captopril and Hydrochlorothiazide 25; 15mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Captopril and Hydrochlorothiazide 25; 15mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Captopril and Hydrochlorothiazide 25; 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Captopril and Hydrochlorothiazide 25; 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Captopril and Hydrochlorothiazide 50; 15mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Captopril and Hydrochlorothiazide 50; 15mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Captopril and Hydrochlorothiazide 50; 25mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Captopril and Hydrochlorothiazide 50; 25mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARAFATE SUS 1GM/10ML ![Compare how all Medicare Part D PDP plans in NY cover CARAFATE SUS 1GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARBAGLU 200 MG DISPER TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARBAGLU 200 MG DISPER TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
CARBAMAZEPINE 100 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE 100 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE 200 MG TABLET [Tegretol] ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE 200 MG TABLET [Tegretol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBAMAZEPINE ER 100 MG CAPSULE CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE ER 100 MG CAPSULE CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE ER 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE ER 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE ER 200 MG CAPSULE CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE ER 200 MG CAPSULE CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE ER 300 MG CAPSULE CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE ER 300 MG CAPSULE CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE XR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE XR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBAMAZEPINE XR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARBAMAZEPINE XR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA AND LEVEDOPA ORALLY DISINTEGRATING TABLETS 10;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA AND LEVODOPA ODT 25;100MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA AND LEVODOPA ODT 25;100MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA AND LEVODOPA ODT 25;250MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA AND LEVODOPA ODT 25;250MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA-LEVO ER 25-100 TABLET [SINEMET CR] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVO ER 25-100 TABLET [SINEMET CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA-LEVO ER 50-200 TABLET [SINEMET CR] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVO ER 50-200 TABLET [SINEMET CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA-LEVODOPA 10-100 TABLET [SINEMET] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 10-100 TABLET [SINEMET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA-LEVODOPA 100 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 100 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARBIDOPA-LEVODOPA 125 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 125 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARBIDOPA-LEVODOPA 150 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 150 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARBIDOPA-LEVODOPA 200 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 200 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARBIDOPA-LEVODOPA 25-100 TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 25-100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA-LEVODOPA 25-250 TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 25-250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARBIDOPA-LEVODOPA 75 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA 75 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARBIDOPA-LEVODOPA-ENTACAPONE 50 MG [Stalevo] ![Compare how all Medicare Part D PDP plans in NY cover CARBIDOPA-LEVODOPA-ENTACAPONE 50 MG [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARTEOLOL HCL 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NY cover CARTEOLOL HCL 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NY cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARTIA XT 180MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NY cover CARTIA XT 180MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NY cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARTIA XT 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CARTIA XT 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CARVEDILOL 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$0.00 | $0.00 | None |
CARVEDILOL 25 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL 25 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$0.00 | $0.00 | None |
CARVEDILOL 3.125 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL 3.125 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$0.00 | $0.00 | None |
CARVEDILOL 6.25 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL 6.25 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$0.00 | $0.00 | None |
CARVEDILOL ER 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL ER 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARVEDILOL ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARVEDILOL ER 40 MG CAPSULE CPMP 24HR [Coreg CR] ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL ER 40 MG CAPSULE CPMP 24HR [Coreg CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CARVEDILOL ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CARVEDILOL ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAYSTON KIT 75 MG/VIAL ![Compare how all Medicare Part D PDP plans in NY cover CAYSTON KIT 75 MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CAZIANT 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in NY cover CAZIANT 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFACLOR 250 MG CAPSULES ![Compare how all Medicare Part D PDP plans in NY cover CEFACLOR 250 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFACLOR 500 MG CAPSULES ![Compare how all Medicare Part D PDP plans in NY cover CEFACLOR 500 MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFADROXIL 1 GM TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEFADROXIL 1 GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFADROXIL 250 MG/5 ML ORAL SUSPENSION [Duricef] ![Compare how all Medicare Part D PDP plans in NY cover CEFADROXIL 250 MG/5 ML ORAL SUSPENSION [Duricef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFADROXIL 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CEFADROXIL 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFADROXIL 500 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEFADROXIL 500 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFAZOLIN 1 GM VIAL 25/Box ![Compare how all Medicare Part D PDP plans in NY cover CEFAZOLIN 1 GM VIAL 25/Box.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE ![Compare how all Medicare Part D PDP plans in NY cover Cefazolin 10g/1 10 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 PACKAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFAZOLIN 500 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover CEFAZOLIN 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFDINIR 125 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEFDINIR 125 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFDINIR 250 MG/5 ML ORAL SUSPENSION [Omnicef] ![Compare how all Medicare Part D PDP plans in NY cover CEFDINIR 250 MG/5 ML ORAL SUSPENSION [Omnicef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFDINIR 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CEFDINIR 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFEPIME HCL 1 GM VIAL [Maxipime] ![Compare how all Medicare Part D PDP plans in NY cover CEFEPIME HCL 1 GM VIAL [Maxipime].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFEPIME HCL 2 GRAM VIAL [Maxipime] ![Compare how all Medicare Part D PDP plans in NY cover CEFEPIME HCL 2 GRAM VIAL [Maxipime].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFIXIME 100 MG/5 ML SUSPENSION [Suprax] ![Compare how all Medicare Part D PDP plans in NY cover CEFIXIME 100 MG/5 ML SUSPENSION [Suprax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFIXIME 200 MG/5 ML SUSPENSION [Suprax] ![Compare how all Medicare Part D PDP plans in NY cover CEFIXIME 200 MG/5 ML SUSPENSION [Suprax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFIXIME 400 MG CAPSULE [Suprax] ![Compare how all Medicare Part D PDP plans in NY cover CEFIXIME 400 MG CAPSULE [Suprax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFOTETAN 1GM VIAL 1EA x 10 ![Compare how all Medicare Part D PDP plans in NY cover CEFOTETAN 1GM VIAL 1EA x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFOTETAN 2GM VIAL 1EA x 10 ![Compare how all Medicare Part D PDP plans in NY cover CEFOTETAN 2GM VIAL 1EA x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFOXITIN 1 GM VIAL [Mefoxin] ![Compare how all Medicare Part D PDP plans in NY cover CEFOXITIN 1 GM VIAL [Mefoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFOXITIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in NY cover CEFOXITIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFOXITIN 2 GM VIAL [Mefoxin] ![Compare how all Medicare Part D PDP plans in NY cover CEFOXITIN 2 GM VIAL [Mefoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPODOXIME 100 MG TABLET [Vantin] ![Compare how all Medicare Part D PDP plans in NY cover CEFPODOXIME 100 MG TABLET [Vantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPODOXIME 100 MG/5 ML ORAL SUSPENSION [Vantin] ![Compare how all Medicare Part D PDP plans in NY cover CEFPODOXIME 100 MG/5 ML ORAL SUSPENSION [Vantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPODOXIME 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEFPODOXIME 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPODOXIME 50 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEFPODOXIME 50 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPROZIL 125 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEFPROZIL 125 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPROZIL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEFPROZIL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPROZIL 250 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEFPROZIL 250 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFPROZIL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEFPROZIL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFTAZIDIME 1 GM VIAL [Tazidime] ![Compare how all Medicare Part D PDP plans in NY cover CEFTAZIDIME 1 GM VIAL [Tazidime].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN ![Compare how all Medicare Part D PDP plans in NY cover CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFTRIAXONE 1 GM VIAL ![Compare how all Medicare Part D PDP plans in NY cover CEFTRIAXONE 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFTRIAXONE 10 GM VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in NY cover CEFTRIAXONE 10 GM VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFTRIAXONE 2 GM VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in NY cover CEFTRIAXONE 2 GM VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFTRIAXONE 250 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover CEFTRIAXONE 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFTRIAXONE 500 MG VIAL ![Compare how all Medicare Part D PDP plans in NY cover CEFTRIAXONE 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFUROXIME 1.5 GM/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in NY cover CEFUROXIME 1.5 GM/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFUROXIME 750 MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in NY cover CEFUROXIME 750 MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFUROXIME AXETIL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEFUROXIME AXETIL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFUROXIME AXETIL 500 MG TABLET [Ceftin] ![Compare how all Medicare Part D PDP plans in NY cover CEFUROXIME AXETIL 500 MG TABLET [Ceftin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEFUROXIME SOD 7.5 GM VIAL [Zinacef] ![Compare how all Medicare Part D PDP plans in NY cover CEFUROXIME SOD 7.5 GM VIAL [Zinacef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CELECOXIB 100 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in NY cover CELECOXIB 100 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CELECOXIB 200 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in NY cover CELECOXIB 200 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CELECOXIB 400 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in NY cover CELECOXIB 400 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CELECOXIB 50 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in NY cover CELECOXIB 50 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CELONTIN 300 MG KAPSEAL ![Compare how all Medicare Part D PDP plans in NY cover CELONTIN 300 MG KAPSEAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CEPHALEXIN 125 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEPHALEXIN 125 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEPHALEXIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CEPHALEXIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEPHALEXIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEPHALEXIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEPHALEXIN 250 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CEPHALEXIN 250 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEPHALEXIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CEPHALEXIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CEPHALEXIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CEPHALEXIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEVIMELINE HCL 30 MG CAPSULE [Evoxac] ![Compare how all Medicare Part D PDP plans in NY cover CEVIMELINE HCL 30 MG CAPSULE [Evoxac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CHANTIX 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHANTIX 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CHANTIX 1 MG CONT MONTH BOX ![Compare how all Medicare Part D PDP plans in NY cover CHANTIX 1 MG CONT MONTH BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CHANTIX 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHANTIX 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CHANTIX STARTING MONTH BOX ![Compare how all Medicare Part D PDP plans in NY cover CHANTIX STARTING MONTH BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CHEMET 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CHEMET 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CHLORDIAZEPOXIDE 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CHLORDIAZEPOXIDE 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHLORDIAZEPOXIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CHLORDIAZEPOXIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHLORDIAZEPOXIDE 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CHLORDIAZEPOXIDE 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHLORHEXIDINE GLUCONATE 0.12% RINSE ![Compare how all Medicare Part D PDP plans in NY cover CHLORHEXIDINE GLUCONATE 0.12% RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHLOROQUINE PH 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLOROQUINE PH 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLOROQUINE PH 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLOROQUINE PH 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHLORPROMAZINE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORPROMAZINE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CHLORPROMAZINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORPROMAZINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CHLORPROMAZINE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORPROMAZINE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CHLORPROMAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORPROMAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CHLORPROMAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORPROMAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CHLORTHALIDONE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORTHALIDONE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHLORTHALIDONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CHLORTHALIDONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHOLESTYRAMINE LIGHT POWDER ![Compare how all Medicare Part D PDP plans in NY cover CHOLESTYRAMINE LIGHT POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CHOLESTYRAMINE PACKET ![Compare how all Medicare Part D PDP plans in NY cover CHOLESTYRAMINE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CICLOPIROX 0.77% CREAM (g) [Loprox] ![Compare how all Medicare Part D PDP plans in NY cover CICLOPIROX 0.77% CREAM (g) [Loprox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CICLOPIROX 0.77% GEL ![Compare how all Medicare Part D PDP plans in NY cover CICLOPIROX 0.77% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CICLOPIROX 0.77% TOPICAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CICLOPIROX 0.77% TOPICAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CICLOPIROX 1% SHAMPOO ![Compare how all Medicare Part D PDP plans in NY cover CICLOPIROX 1% SHAMPOO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CICLOPIROX 8% SOLUTION [Penlac] ![Compare how all Medicare Part D PDP plans in NY cover CICLOPIROX 8% SOLUTION [Penlac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Cilastatin 250 MG / Imipenem 250 MG Injection ![Compare how all Medicare Part D PDP plans in NY cover Cilastatin 250 MG / Imipenem 250 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Cilastatin 500 MG / Imipenem 500 MG Injection ![Compare how all Medicare Part D PDP plans in NY cover Cilastatin 500 MG / Imipenem 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CILOSTAZOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CILOSTAZOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CILOSTAZOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CILOSTAZOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CILOXAN 0.3% OINTMENT ![Compare how all Medicare Part D PDP plans in NY cover CILOXAN 0.3% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CIMDUO 300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CIMDUO 300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
CINACALCET HCL 30 MG TABLET [Sensipar] ![Compare how all Medicare Part D PDP plans in NY cover CINACALCET HCL 30 MG TABLET [Sensipar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CINACALCET HCL 60 MG TABLET [Sensipar] ![Compare how all Medicare Part D PDP plans in NY cover CINACALCET HCL 60 MG TABLET [Sensipar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
CINACALCET HCL 90 MG TABLET [Sensipar] ![Compare how all Medicare Part D PDP plans in NY cover CINACALCET HCL 90 MG TABLET [Sensipar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
Cinryze 500[iU]/5mL 1 VIAL per CARTON / 5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NY cover Cinryze 500[iU]/5mL 1 VIAL per CARTON / 5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CIPRO HC OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CIPRO HC OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CIPRODEX OTIC SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CIPRODEX OTIC SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CIPROFLOXACIN 0.2% OTIC SOLN DROPERETTE [Cetraxal] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN 0.2% OTIC SOLN DROPERETTE [Cetraxal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CIPROFLOXACIN 0.3% EYE DROPS [Ciloxan] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN 0.3% EYE DROPS [Ciloxan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CIPROFLOXACIN HCL 100 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN HCL 100 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CIPROFLOXACIN HCL 250 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN HCL 250 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CIPROFLOXACIN HCL 500 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN HCL 500 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CIPROFLOXACIN HCL 750 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN HCL 750 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPROFLOXACIN-D5W 200 MG/100 ML PIGGYBACK [Cipro] ![Compare how all Medicare Part D PDP plans in NY cover CIPROFLOXACIN-D5W 200 MG/100 ML PIGGYBACK [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CITALOPRAM HBR 10 MG TABLET [Celexa] ![Compare how all Medicare Part D PDP plans in NY cover CITALOPRAM HBR 10 MG TABLET [Celexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CITALOPRAM HBR 10 MG/5 ML SOLUTION [Celexa] ![Compare how all Medicare Part D PDP plans in NY cover CITALOPRAM HBR 10 MG/5 ML SOLUTION [Celexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CITALOPRAM HBR 20 MG TABLET [Celexa] ![Compare how all Medicare Part D PDP plans in NY cover CITALOPRAM HBR 20 MG TABLET [Celexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CITALOPRAM HBR 40 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CITALOPRAM HBR 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLARITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLARITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLARITHROMYCIN 500 MG TABLET [Biaxin] ![Compare how all Medicare Part D PDP plans in NY cover CLARITHROMYCIN 500 MG TABLET [Biaxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLARITHROMYCIN ER 500 MG TABLET 24H [Biaxin XL] ![Compare how all Medicare Part D PDP plans in NY cover CLARITHROMYCIN ER 500 MG TABLET 24H [Biaxin XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLEOCIN 100 MG VAGINAL OVULE ![Compare how all Medicare Part D PDP plans in NY cover CLEOCIN 100 MG VAGINAL OVULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLIND PH-BENZOYL PEROX 1.2-5% [Benzaclin] ![Compare how all Medicare Part D PDP plans in NY cover CLIND PH-BENZOYL PEROX 1.2-5% [Benzaclin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CLINDAMYCIN 150mg/ml vl 25x6ml ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN 150mg/ml vl 25x6ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN 2% VAGINAL CREAM w/APPL [Clindesse] ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN 2% VAGINAL CREAM w/APPL [Clindesse].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN HCL 150 MG CAPSULE [Cleocin] ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN HCL 150 MG CAPSULE [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN HCL 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN HCL 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN HCL 75 MG 200 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN HCL 75 MG 200 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN PEDIATR 75 MG/5 ML SOLN RECON [Cleocin Pediatric] ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PEDIATR 75 MG/5 ML SOLN RECON [Cleocin Pediatric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN PH 1% SOLUTION ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PH 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN PH 300 MG/2 ML VIAL [Cleocin] ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PH 300 MG/2 ML VIAL [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN PH 600 MG/4 ML VIAL [Cleocin] ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PH 600 MG/4 ML VIAL [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN PHOSP 1% LOTION [ClindaMax] ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PHOSP 1% LOTION [ClindaMax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PHOSPHATE GEL 1% 30GRAM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in NY cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Clindamycin-d5w 300 mg/50 ml ![Compare how all Medicare Part D PDP plans in NY cover Clindamycin-d5w 300 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Clindamycin-d5w 600 mg/50 ml ![Compare how all Medicare Part D PDP plans in NY cover Clindamycin-d5w 600 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Clindamycin-d5w 900 mg/50 ml ![Compare how all Medicare Part D PDP plans in NY cover Clindamycin-d5w 900 mg/50 ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOBAZAM 10 MG TABLET [ONFI] ![Compare how all Medicare Part D PDP plans in NY cover CLOBAZAM 10 MG TABLET [ONFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION [ONFI] ![Compare how all Medicare Part D PDP plans in NY cover CLOBAZAM 2.5 MG/ML ORAL SUSPENSION [ONFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CLOBAZAM 20 MG TABLET [ONFI] ![Compare how all Medicare Part D PDP plans in NY cover CLOBAZAM 20 MG TABLET [ONFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CLOBETASOL 0.05% CREAM (g) [Temovate] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL 0.05% CREAM (g) [Temovate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
CLOBETASOL 0.05% OINTMENT [Temovate E] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL 0.05% OINTMENT [Temovate E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
CLOBETASOL 0.05% SOLUTION [Temovate] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL 0.05% SOLUTION [Temovate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:100 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOBETASOL 0.05% TOPICAL LOTION [Clobex] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL 0.05% TOPICAL LOTION [Clobex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
CLOBETASOL EMOLLIENT 0.05% CREAM (g) [Temovate E] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL EMOLLIENT 0.05% CREAM (g) [Temovate E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
CLOBETASOL EMOLLNT 0.05% FOAM [Olux-E] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL EMOLLNT 0.05% FOAM [Olux-E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:100 /30Days |
CLOBETASOL PROP 0.05% FOAM [Olux] ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL PROP 0.05% FOAM [Olux].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:100 /30Days |
CLOBETASOL PROP 0.05% SPRAY ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL PROP 0.05% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
Clobetasol Propionate 0.5 MG/ML Medicated Shampoo ![Compare how all Medicare Part D PDP plans in NY cover Clobetasol Propionate 0.5 MG/ML Medicated Shampoo.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE ![Compare how all Medicare Part D PDP plans in NY cover CLOBETASOL PROPIONATE GEL .05% 60 GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
CLOCORTOLONE PIVALATE 0.1% CREAM (g) [Cloderm] ![Compare how all Medicare Part D PDP plans in NY cover CLOCORTOLONE PIVALATE 0.1% CREAM (g) [Cloderm].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOMIPRAMINE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CLOMIPRAMINE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CLOMIPRAMINE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CLOMIPRAMINE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CLONAZEPAM 0.125 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 0.125 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLONAZEPAM 0.25 MG ODT TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 0.25 MG ODT TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONAZEPAM 0.5 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 0.5 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONAZEPAM 1 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 1 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONAZEPAM 2 MG ODT TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 2 MG ODT TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONAZEPAM 2 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in NY cover CLONAZEPAM 2 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONIDINE HCL 0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLONIDINE HCL 0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONIDINE HCL 0.2 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLONIDINE HCL 0.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLONIDINE HCL 0.3 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLONIDINE HCL 0.3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOPIDOGREL 75 MG TABLET [Plavix] ![Compare how all Medicare Part D PDP plans in NY cover CLOPIDOGREL 75 MG TABLET [Plavix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLORAZEPATE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLORAZEPATE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLORAZEPATE 3.75 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLORAZEPATE 3.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLORAZEPATE 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLORAZEPATE 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOTRIMAZOLE 1% CREAM (g) [Mycelex] ![Compare how all Medicare Part D PDP plans in NY cover CLOTRIMAZOLE 1% CREAM (g) [Mycelex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOTRIMAZOLE 1% SOLUTION ![Compare how all Medicare Part D PDP plans in NY cover CLOTRIMAZOLE 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | Q:90 /30Days |
CLOTRIMAZOLE 10 MG TROCHE ![Compare how all Medicare Part D PDP plans in NY cover CLOTRIMAZOLE 10 MG TROCHE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NY cover CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE 0.64; 10mg/g; mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | Q:90 /30Days |
CLOVIQUE 250 MG CAPSULE [Syprine] ![Compare how all Medicare Part D PDP plans in NY cover CLOVIQUE 250 MG CAPSULE [Syprine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
CLOZAPINE 100 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE 100 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOZAPINE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOZAPINE 25 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE 25 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOZAPINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CLOZAPINE ODT 100 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE ODT 100 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CLOZAPINE ODT 12.5 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE ODT 12.5 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CLOZAPINE ODT 150 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE ODT 150 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
CLOZAPINE ODT 200 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE ODT 200 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
CLOZAPINE ODT 25 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in NY cover CLOZAPINE ODT 25 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
COARTEM 20MG-120MG ![Compare how all Medicare Part D PDP plans in NY cover COARTEM 20MG-120MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
COLCHICINE 0.6 MG TABLET [Colcrys] ![Compare how all Medicare Part D PDP plans in NY cover COLCHICINE 0.6 MG TABLET [Colcrys].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | Q:60 /30Days |
COLESEVELAM 625 MG TABLET [WelChol] ![Compare how all Medicare Part D PDP plans in NY cover COLESEVELAM 625 MG TABLET [WelChol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
COLESTIPOL HCL GRANULES PACKET [Colestid] ![Compare how all Medicare Part D PDP plans in NY cover COLESTIPOL HCL GRANULES PACKET [Colestid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
COLESTIPOL MICRONIZED 1 GM TABLET [Colestid] ![Compare how all Medicare Part D PDP plans in NY cover COLESTIPOL MICRONIZED 1 GM TABLET [Colestid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COLISTIMETHATE 150 MG VIAL [Coly-Mycin M] ![Compare how all Medicare Part D PDP plans in NY cover COLISTIMETHATE 150 MG VIAL [Coly-Mycin M].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
COMBIGAN 0.2%-0.5% DROPS ![Compare how all Medicare Part D PDP plans in NY cover COMBIGAN 0.2%-0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
COMBIVENT RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover COMBIVENT RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
COMETRIQ 100 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in NY cover COMETRIQ 100 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
COMETRIQ 140 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in NY cover COMETRIQ 140 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
COMETRIQ 60 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in NY cover COMETRIQ 60 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in NY cover COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | None |
COMPRO 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in NY cover COMPRO 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CONSTULOSE 10 GM/15 ML SOLN ![Compare how all Medicare Part D PDP plans in NY cover CONSTULOSE 10 GM/15 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
COPIKTRA 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover COPIKTRA 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
COPIKTRA 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover COPIKTRA 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CORLANOR 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CORLANOR 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CORLANOR 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CORLANOR 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Cortisone 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover Cortisone 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
COTELLIC 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover COTELLIC 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |
Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CREON DR 36,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CREON DR 36,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CRIXIVAN 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CRIXIVAN 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CRIXIVAN 400mg, 180 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CRIXIVAN 400mg, 180 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom] ![Compare how all Medicare Part D PDP plans in NY cover CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CROMOLYN 20 MG/2 ML NEB SOLN AMPUL-NEB [Intal] ![Compare how all Medicare Part D PDP plans in NY cover CROMOLYN 20 MG/2 ML NEB SOLN AMPUL-NEB [Intal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | P |
CROMOLYN SODIUM 4% 40MG 10ML BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CROMOLYN SODIUM 4% 40MG 10ML BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CYCLAFEM 1-35-28 TABLET [Pirmella] ![Compare how all Medicare Part D PDP plans in NY cover CYCLAFEM 1-35-28 TABLET [Pirmella].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CYCLAFEM 7-7-7-28 TABLET ![Compare how all Medicare Part D PDP plans in NY cover CYCLAFEM 7-7-7-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | None |
CYCLOBENZAPRINE 10 MG TABLET [Flexeril] ![Compare how all Medicare Part D PDP plans in NY cover CYCLOBENZAPRINE 10 MG TABLET [Flexeril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CYCLOBENZAPRINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CYCLOBENZAPRINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CYCLOPHOSPHAMIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CYCLOPHOSPHAMIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
CYCLOPHOSPHAMIDE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CYCLOPHOSPHAMIDE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOSPORINE MODIFIED 100 MG ![Compare how all Medicare Part D PDP plans in NY cover CYCLOSPORINE MODIFIED 100 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | P |
CYCLOSPORINE MODIFIED 25 MG ![Compare how all Medicare Part D PDP plans in NY cover CYCLOSPORINE MODIFIED 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | P |
CYCLOSPORINE MODIFIED 50 MG ![Compare how all Medicare Part D PDP plans in NY cover CYCLOSPORINE MODIFIED 50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOTTLE ![Compare how all Medicare Part D PDP plans in NY cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$12.00 | $24.00 | P |
CYPROHEPTADINE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover CYPROHEPTADINE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CYSTADANE 1 GRAM/1.7 ML POWDER ![Compare how all Medicare Part D PDP plans in NY cover CYSTADANE 1 GRAM/1.7 ML POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$47.00 | $94.00 | None |
CYSTARAN 0.44% EYE DROPS ![Compare how all Medicare Part D PDP plans in NY cover CYSTARAN 0.44% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
27% | N/A | P |