2020 Medicare Part D Plan Formulary Information |
ATRIO Gold Rx (Willamette) (PPO) (H7006-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for ATRIO Gold Rx (Willamette) (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The ATRIO Gold Rx (Willamette) (PPO) (H7006-001-0) Formulary Drugs Starting with the Letter A in Marion County, OR: CMS MA Region 23 which includes: OR Plan Monthly Premium: $190.00 Deductible: $0 |
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ABACAVIR 20 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover ABACAVIR 20 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ABACAVIR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ABACAVIR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in OR cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ABACAVIR-LAMIVUDINE 600-300 MG TABLET [Epzicom] ![Compare how all Medicare Part D PDP plans in OR cover ABACAVIR-LAMIVUDINE 600-300 MG TABLET [Epzicom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ABELCET INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in OR cover ABELCET INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ABILIFY MAINTENA ER 300 MG SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ABILIFY MAINTENA ER 300 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 300 MG VIAL ![Compare how all Medicare Part D PDP plans in OR cover ABILIFY MAINTENA ER 300 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 400 MG SUSER VIAL ![Compare how all Medicare Part D PDP plans in OR cover ABILIFY MAINTENA ER 400 MG SUSER VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:1 /28Days |
ABILIFY MAINTENA ER 400 MG SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ABILIFY MAINTENA ER 400 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:1 /28Days |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in OR cover Acamprosate Calcium DR 333 MG tablets [Campral].](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 |
ACARBOSE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACARBOSE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:90 /30Days |
ACARBOSE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACARBOSE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:90 /30Days |
ACARBOSE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACARBOSE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:90 /30Days |
ACEBUTOLOL 200 MG CAPSULE [Sectral] ![Compare how all Medicare Part D PDP plans in OR cover ACEBUTOLOL 200 MG CAPSULE [Sectral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACEBUTOLOL 400 MG CAPSULE [Sectral] ![Compare how all Medicare Part D PDP plans in OR cover ACEBUTOLOL 400 MG CAPSULE [Sectral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACETAMINOP-CODEINE 120-12 MG/5 ![Compare how all Medicare Part D PDP plans in OR cover ACETAMINOP-CODEINE 120-12 MG/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:4500 /30Days |
ACETAMINOPHEN-COD #2 TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACETAMINOPHEN-COD #2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3] ![Compare how all Medicare Part D PDP plans in OR cover ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:180 /30Days |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACETAZOLAMIDE 250 MG TABLET [Diamox] ![Compare how all Medicare Part D PDP plans in OR cover ACETAZOLAMIDE 250 MG TABLET [Diamox].](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 |
ACETAZOLAMIDE ER 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover ACETAZOLAMIDE ER 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACETIC ACID 2% EAR SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover ACETIC ACID 2% EAR SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in OR cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
ACETYLCYSTEINE 20% VIAL [Mucosil Acetylcysteine] ![Compare how all Medicare Part D PDP plans in OR cover ACETYLCYSTEINE 20% VIAL [Mucosil Acetylcysteine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in OR cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in OR cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in OR cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACTEMRA 162 MG/0.9 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ACTEMRA 162 MG/0.9 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ACTEMRA ACTPEN 162 MG/0.9 ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in OR cover ACTEMRA ACTPEN 162 MG/0.9 ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ACTHIB VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in OR cover ACTHIB VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in OR cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACYCLOVIR 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover ACYCLOVIR 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACYCLOVIR 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OR cover ACYCLOVIR 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACYCLOVIR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACYCLOVIR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ACYCLOVIR 5% CREAM (g) [Zovirax] ![Compare how all Medicare Part D PDP plans in OR cover ACYCLOVIR 5% CREAM (g) [Zovirax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:5 /4Days |
ACYCLOVIR 5% OINTMENT [Zovirax] ![Compare how all Medicare Part D PDP plans in OR cover ACYCLOVIR 5% OINTMENT [Zovirax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /30Days |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in OR cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
ADACEL TDAP SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ADACEL TDAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in OR cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA] ![Compare how all Medicare Part D PDP plans in OR cover ADALIMUMAB 50 MG/ML PREFILLED SYRINGE [HUMIRA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ADAPALENE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in OR cover ADAPALENE 0.1% CREAM.](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 |
ADAPALENE 0.1% GEL ![Compare how all Medicare Part D PDP plans in OR cover ADAPALENE 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ADEFOVIR DIPIVOXIL 10 MG TABLET [Hepsera] ![Compare how all Medicare Part D PDP plans in OR cover ADEFOVIR DIPIVOXIL 10 MG TABLET [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
ADVAIR DISKUS MIS 100/50 ![Compare how all Medicare Part D PDP plans in OR cover ADVAIR DISKUS MIS 100/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 250/50 ![Compare how all Medicare Part D PDP plans in OR cover ADVAIR DISKUS MIS 250/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ADVAIR DISKUS MIS 500/50 ![Compare how all Medicare Part D PDP plans in OR cover ADVAIR DISKUS MIS 500/50.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in OR cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:12 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADVAIR HFA INHALER 115;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in OR cover ADVAIR HFA INHALER 115;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:12 /28Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in OR cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:12 /28Days |
AFINITOR 10 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AFINITOR 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:56 /28Days |
AFINITOR 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AFINITOR 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:28 /28Days |
AFINITOR 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AFINITOR 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:28 /28Days |
Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in OR cover Afinitor 7.5mg/1 28 BLISTER PACK per CARTON / 1 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:28 /28Days |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:112 /28Days |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:112 /28Days |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:112 /28Days |
AIMOVIG 140 MG/ML AUTOINJECTOR ![Compare how all Medicare Part D PDP plans in OR cover AIMOVIG 140 MG/ML AUTOINJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | P Q:1 /30Days |
AIMOVIG 70 MG/ML AUTOINJECTOR ![Compare how all Medicare Part D PDP plans in OR cover AIMOVIG 70 MG/ML AUTOINJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | P Q:1 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AJOVY 225 MG/1.5 ML AUTOINJECT ![Compare how all Medicare Part D PDP plans in OR cover AJOVY 225 MG/1.5 ML AUTOINJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | P Q:2 /30Days |
AJOVY 225 MG/1.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover AJOVY 225 MG/1.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | P Q:2 /30Days |
ALA-SCALP HP 2% LOTION ![Compare how all Medicare Part D PDP plans in OR cover ALA-SCALP HP 2% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
ALBENDAZOLE 200 MG TABLET [Albenza] ![Compare how all Medicare Part D PDP plans in OR cover ALBENDAZOLE 200 MG TABLET [Albenza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ALBUTEROL 2.5 MG/0.5 ML SOL VIAL-NEB ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL 2.5 MG/0.5 ML SOL VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:36 /30Days |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:13 /30Days |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:17 /30Days |
ALBUTEROL SUL 0.63 MG/3 ML SOL VIAL-NEB ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SUL 0.63 MG/3 ML SOL VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
ALBUTEROL SUL 1.25 MG/3 ML SOL VIAL-NEB ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SUL 1.25 MG/3 ML SOL VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
ALBUTEROL SUL 2.5 MG/3 ML SOLN ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SUL 2.5 MG/3 ML SOLN.](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 |
ALBUTEROL SULFATE 2 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SULFATE 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SULFATE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE 4MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SULFATE 4MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE 8MG TABLET SR 12HR ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SULFATE 8MG TABLET SR 12HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOTTLE ![Compare how all Medicare Part D PDP plans in OR cover ALBUTEROL SULFATE SYRUP 2MG/5ML 16 FLO BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALCLOMETASONE DIPR 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in OR cover ALCLOMETASONE DIPR 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALCLOMETASONE DIPRO 0.05% CREAM ![Compare how all Medicare Part D PDP plans in OR cover ALCLOMETASONE DIPRO 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALECENSA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover ALECENSA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:240 /30Days |
ALENDRONATE SODIUM 10 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in OR cover ALENDRONATE SODIUM 10 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ALENDRONATE SODIUM 35 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in OR cover ALENDRONATE SODIUM 35 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:4 /28Days |
ALENDRONATE SODIUM 70 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in OR cover ALENDRONATE SODIUM 70 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 70 MG/75 ML ![Compare how all Medicare Part D PDP plans in OR cover ALENDRONATE SODIUM 70 MG/75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:300 /28Days |
ALFUZOSIN HCL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALFUZOSIN HCL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ALINIA 100 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in OR cover ALINIA 100 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ALINIA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALINIA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Aliskiren 150 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in OR cover Aliskiren 150 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | S |
Aliskiren 150 MG / Hydrochlorothiazide 25 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in OR cover Aliskiren 150 MG / Hydrochlorothiazide 25 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | S |
ALISKIREN 150 MG TABLET [Tekturna] ![Compare how all Medicare Part D PDP plans in OR cover ALISKIREN 150 MG TABLET [Tekturna].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Aliskiren 300 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT] ![Compare how all Medicare Part D PDP plans in OR cover Aliskiren 300 MG / Hydrochlorothiazide 12.5 MG Oral Tablet [Tekturna HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | S |
ALISKIREN 300 MG TABLET [Tekturna] ![Compare how all Medicare Part D PDP plans in OR cover ALISKIREN 300 MG TABLET [Tekturna].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
ALLOPURINOL 100 MG TABLET [Zyloprim] ![Compare how all Medicare Part D PDP plans in OR cover ALLOPURINOL 100 MG TABLET [Zyloprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ALLOPURINOL 300 MG TABLET [Zyloprim] ![Compare how all Medicare Part D PDP plans in OR cover ALLOPURINOL 300 MG TABLET [Zyloprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALOSETRON HCL 0.5 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in OR cover ALOSETRON HCL 0.5 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ALOSETRON HCL 1 MG TABLET [Lotronex] ![Compare how all Medicare Part D PDP plans in OR cover ALOSETRON HCL 1 MG TABLET [Lotronex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ALPHAGAN P 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in OR cover ALPHAGAN P 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | None |
ALPRAZOLAM 0.25 MG TABLET [Xanax] ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM 0.25 MG TABLET [Xanax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:120 /30Days |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:120 /30Days |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:120 /30Days |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | Q:150 /30Days |
ALPRAZOLAM ER 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM ER 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:120 /30Days |
ALPRAZOLAM ER 1 MG TABLET 24H [Xanax XR] ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM ER 1 MG TABLET 24H [Xanax XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:120 /30Days |
ALPRAZOLAM ER 2 MG TABLET 24H [Xanax XR] ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM ER 2 MG TABLET 24H [Xanax XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:120 /30Days |
ALPRAZOLAM ER 3 MG TABLET 24H [Xanax XR] ![Compare how all Medicare Part D PDP plans in OR cover ALPRAZOLAM ER 3 MG TABLET 24H [Xanax XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALREX 0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in OR cover ALREX 0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | S |
ALTAVERA-28 TABLET [Portia] ![Compare how all Medicare Part D PDP plans in OR cover ALTAVERA-28 TABLET [Portia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALTRENO 0.05% LOTION ![Compare how all Medicare Part D PDP plans in OR cover ALTRENO 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P |
ALUNBRIG 180 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALUNBRIG 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
ALUNBRIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALUNBRIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:120 /30Days |
ALUNBRIG 90 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALUNBRIG 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
ALUNBRIG 90 MG-180 MG TABLET PACK ![Compare how all Medicare Part D PDP plans in OR cover ALUNBRIG 90 MG-180 MG TABLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ALYACEN 1-35-28 TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALYACEN 1-35-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ALYQ 20 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ALYQ 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
Amabelz 0.5 MG/0.1 MG 28 TABLET/BLISTER PACK 3 PER CARTON ![Compare how all Medicare Part D PDP plans in OR cover Amabelz 0.5 MG/0.1 MG 28 TABLET/BLISTER PACK 3 PER CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
Amabelz 1 MG/0.5 MG 28 TABLET/BLISTER PACK 3 PER CARTON ![Compare how all Medicare Part D PDP plans in OR cover Amabelz 1 MG/0.5 MG 28 TABLET/BLISTER PACK 3 PER CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMANTADINE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover AMANTADINE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMANTADINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMANTADINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMANTADINE 50 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover AMANTADINE 50 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMBISOME 50MG VIAL ![Compare how all Medicare Part D PDP plans in OR cover AMBISOME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
AMBRISENTAN 10 MG TABLET [LETAIRIS] ![Compare how all Medicare Part D PDP plans in OR cover AMBRISENTAN 10 MG TABLET [LETAIRIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AMBRISENTAN 5 MG TABLET [LETAIRIS] ![Compare how all Medicare Part D PDP plans in OR cover AMBRISENTAN 5 MG TABLET [LETAIRIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AMETHIA 0.15-0.03-0.01 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMETHIA 0.15-0.03-0.01 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:91 /84Days |
AMETHIA LO TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMETHIA LO TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:91 /84Days |
AMILORIDE HCL 5 MG TABLET [Midamor] ![Compare how all Medicare Part D PDP plans in OR cover AMILORIDE HCL 5 MG TABLET [Midamor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMILORIDE HCL-HCTZ 5-50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMILORIDE HCL-HCTZ 5-50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10] ![Compare how all Medicare Part D PDP plans in OR cover Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5] ![Compare how all Medicare Part D PDP plans in OR cover Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P |
AMINOSYN II 10% SOL 6X2000 ML ![Compare how all Medicare Part D PDP plans in OR cover AMINOSYN II 10% SOL 6X2000 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P |
AMIODARONE HCL 100 MG TABLET [Pacerone] ![Compare how all Medicare Part D PDP plans in OR cover AMIODARONE HCL 100 MG TABLET [Pacerone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMIODARONE HCL 200 MG TABLET [Pacerone] ![Compare how all Medicare Part D PDP plans in OR cover AMIODARONE HCL 200 MG TABLET [Pacerone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMIODARONE HCL 400 MG TABLET [Pacerone] ![Compare how all Medicare Part D PDP plans in OR cover AMIODARONE HCL 400 MG TABLET [Pacerone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMITIZA 24 MCG 60 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in OR cover AMITIZA 24 MCG 60 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:60 /30Days |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:60 /30Days |
AMITRIP/CDP 25-10 TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIP/CDP 25-10 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIP/PERPHEN 10-4 TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIP/PERPHEN 10-4 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 |
AMITRIP/PERPHEN 50-4 TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIP/PERPHEN 50-4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIPTYLINE HCL 10 MG TABLET [Elavil] ![Compare how all Medicare Part D PDP plans in OR cover AMITRIPTYLINE HCL 10 MG TABLET [Elavil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIPTYLINE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIPTYLINE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIPTYLINE HCL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIPTYLINE HCL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIPTYLINE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIPTYLINE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIPTYLINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIPTYLINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMITRIPTYLINE HCL 75 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMITRIPTYLINE HCL 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMLOD-VALSA-HCTZ 10-160-12.5 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in OR cover AMLOD-VALSA-HCTZ 10-160-12.5 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMLOD-VALSA-HCTZ 10-160-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in OR cover AMLOD-VALSA-HCTZ 10-160-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMLOD-VALSA-HCTZ 10-320-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in OR cover AMLOD-VALSA-HCTZ 10-320-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMLOD-VALSA-HCTZ 5-160-12.5 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in OR cover AMLOD-VALSA-HCTZ 5-160-12.5 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLOD-VALSA-HCTZ 5-160-25 MG [Exforge HCT] ![Compare how all Medicare Part D PDP plans in OR cover AMLOD-VALSA-HCTZ 5-160-25 MG [Exforge HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMLODIPINE BESYLATE 10 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE BESYLATE 10 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMLODIPINE BESYLATE 2.5 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE BESYLATE 2.5 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMLODIPINE BESYLATE 5 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE BESYLATE 5 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMLODIPINE-ATORVAST 10-20 MG [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-ATORVAST 10-20 MG [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMLODIPINE-ATORVAST 10-40 MG [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-ATORVAST 10-40 MG [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 10-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 10-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 10-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 10-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 2.5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 2.5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 2.5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 2.5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 2.5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 2.5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amlodipine-Atorvastatin 5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Amlodipine-Atorvastatin 5-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in OR cover Amlodipine-Atorvastatin 5-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMLODIPINE-BENAZEPRIL 10-20 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-BENAZEPRIL 10-20 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-BENAZEPRIL 10-40 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-BENAZEPRIL 10-40 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-BENAZEPRIL 2.5-10 CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-BENAZEPRIL 2.5-10 CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-BENAZEPRIL 5-10 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-BENAZEPRIL 5-10 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-BENAZEPRIL 5-20 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-BENAZEPRIL 5-20 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-BENAZEPRIL 5-40 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-BENAZEPRIL 5-40 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-OLMESARTAN 10-20 MG TABLET [AZOR] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-OLMESARTAN 10-20 MG TABLET [AZOR].](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 |
AMLODIPINE-OLMESARTAN 10-40 MG TABLET [AZOR] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-OLMESARTAN 10-40 MG TABLET [AZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMLODIPINE-OLMESARTAN 5-20 MG TABLET [AZOR] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-OLMESARTAN 5-20 MG TABLET [AZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMLODIPINE-OLMESARTAN 5-40 MG TABLET [AZOR] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-OLMESARTAN 5-40 MG TABLET [AZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMLODIPINE-VALSARTAN 10-160 MG TABLET [Exforge] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-VALSARTAN 10-160 MG TABLET [Exforge].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-VALSARTAN 10-320 MG TABLET [Exforge] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-VALSARTAN 10-320 MG TABLET [Exforge].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-VALSARTAN 5-160 MG TABLET [Exforge] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-VALSARTAN 5-160 MG TABLET [Exforge].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMLODIPINE-VALSARTAN 5-320 MG TABLET [Exforge] ![Compare how all Medicare Part D PDP plans in OR cover AMLODIPINE-VALSARTAN 5-320 MG TABLET [Exforge].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
AMMONIUM LACTATE 12% CREAM (g) [Lac-Hydrin] ![Compare how all Medicare Part D PDP plans in OR cover AMMONIUM LACTATE 12% CREAM (g) [Lac-Hydrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in OR cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in OR cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in OR cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in OR cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOX-CLAV 200-28.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV 200-28.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOX-CLAV 250-62.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV 250-62.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMOX-CLAV 400-57 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV 400-57 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOX-CLAV 500-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV 500-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOX-CLAV 600-42.9 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV 600-42.9 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOX-CLAV 875-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV 875-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in OR cover AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMOXAPINE 25MG 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 |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMOXICILLIN 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 250 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 250 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 250 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 250 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION [Amoxil] ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION [Amoxil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AMOXICILLIN 875 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMOXICILLIN 875 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
AMPHETAMINE SALTS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AMPHETAMINE SALTS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in OR cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
AMPICILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in OR cover AMPICILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Ampicillin 1000 MG / Sulbactam 500 MG Injection ![Compare how all Medicare Part D PDP plans in OR cover Ampicillin 1000 MG / Sulbactam 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Ampicillin 1000 MG Injection ![Compare how all Medicare Part D PDP plans in OR cover Ampicillin 1000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in OR cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMPICILLIN CAPSULES 500MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in OR cover AMPICILLIN CAPSULES 500MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AMPICILLIN-SULBACTAM 15 GM VIAL [Unasyn] ![Compare how all Medicare Part D PDP plans in OR cover AMPICILLIN-SULBACTAM 15 GM VIAL [Unasyn].](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 |
AMPICILLIN-SULBACTAM 3 GM VIAL [Unasyn] ![Compare how all Medicare Part D PDP plans in OR cover AMPICILLIN-SULBACTAM 3 GM VIAL [Unasyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ANADROL-50 TABLET ![Compare how all Medicare Part D PDP plans in OR cover ANADROL-50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in OR cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in OR cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ANASTROZOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ANASTROZOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in OR cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | None |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in OR cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
Apraclonidine 5 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in OR cover Apraclonidine 5 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
APREPITANT 125 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in OR cover APREPITANT 125 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:2 /28Days |
APREPITANT 125-80-80 MG PACK [Emend] ![Compare how all Medicare Part D PDP plans in OR cover APREPITANT 125-80-80 MG PACK [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:6 /28Days |
APREPITANT 40 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in OR cover APREPITANT 40 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:1 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APREPITANT 80 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in OR cover APREPITANT 80 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:4 /28Days |
APRI 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in OR cover APRI 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:30 /30Days |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:30 /30Days |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:60 /30Days |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:60 /30Days |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT ![Compare how all Medicare Part D PDP plans in OR cover APTIVUS ORAL SOLUTION 100MG/ML 95 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ARANELLE 7-9-5 TABLET ![Compare how all Medicare Part D PDP plans in OR cover ARANELLE 7-9-5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ARCALYST INJECTION 220MG/VIAL ![Compare how all Medicare Part D PDP plans in OR cover ARCALYST INJECTION 220MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:900 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /30Days |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /30Days |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:60 /30Days |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /30Days |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /30Days |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /30Days |
ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | S Q:90 /30Days |
ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt] ![Compare how all Medicare Part D PDP plans in OR cover ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | S Q:60 /30Days |
ARISTADA ER 1064 MG/3.9 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ARISTADA ER 1064 MG/3.9 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:4 /56Days |
ARISTADA ER 441 MG/1.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ARISTADA ER 441 MG/1.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:2 /28Days |
ARISTADA ER 662 MG/2.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ARISTADA ER 662 MG/2.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:2 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARISTADA ER 882 MG/3.2 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ARISTADA ER 882 MG/3.2 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:3 /28Days |
ARISTADA INITIO ER 675 MG/2.4 SUSER SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover ARISTADA INITIO ER 675 MG/2.4 SUSER SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:5 /365Days |
ARMODAFINIL 150 MG TABLET [Nuvigil] ![Compare how all Medicare Part D PDP plans in OR cover ARMODAFINIL 150 MG TABLET [Nuvigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:30 /30Days |
ARMODAFINIL 200 MG TABLET [Nuvigil] ![Compare how all Medicare Part D PDP plans in OR cover ARMODAFINIL 200 MG TABLET [Nuvigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:30 /30Days |
ARMODAFINIL 250 MG TABLET [Nuvigil] ![Compare how all Medicare Part D PDP plans in OR cover ARMODAFINIL 250 MG TABLET [Nuvigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:30 /30Days |
ARMODAFINIL 50 MG TABLET [Nuvigil] ![Compare how all Medicare Part D PDP plans in OR cover ARMODAFINIL 50 MG TABLET [Nuvigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P Q:30 /30Days |
ARNUITY ELLIPTA 100 MCG INH ![Compare how all Medicare Part D PDP plans in OR cover ARNUITY ELLIPTA 100 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:30 /30Days |
ARNUITY ELLIPTA 200 MCG INH ![Compare how all Medicare Part D PDP plans in OR cover ARNUITY ELLIPTA 200 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:30 /30Days |
ARNUITY ELLIPTA 50 MCG INH BLST W/DEV ![Compare how all Medicare Part D PDP plans in OR cover ARNUITY ELLIPTA 50 MCG INH BLST W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:30 /30Days |
ASCOMP WITH CODEINE CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover ASCOMP WITH CODEINE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P Q:180 /30Days |
ASHLYNA 0.15-0.03-0.01 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ASHLYNA 0.15-0.03-0.01 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:91 /84Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Aspirin-Diphenhydramine ER 25-200 MG ![Compare how all Medicare Part D PDP plans in OR cover Aspirin-Diphenhydramine ER 25-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE ![Compare how all Medicare Part D PDP plans in OR cover ASPIRIN/BUTALBITAL/CAFFEINE/CODEINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | P Q:180 /30Days |
ATAZANAVIR SULFATE 150 MG CAPSULE [Reyataz] ![Compare how all Medicare Part D PDP plans in OR cover ATAZANAVIR SULFATE 150 MG CAPSULE [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ATAZANAVIR SULFATE 200 MG CAPSULE [Reyataz] ![Compare how all Medicare Part D PDP plans in OR cover ATAZANAVIR SULFATE 200 MG CAPSULE [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ATAZANAVIR SULFATE 300 MG CAPSULE [Reyataz] ![Compare how all Medicare Part D PDP plans in OR cover ATAZANAVIR SULFATE 300 MG CAPSULE [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ATENOLOL 100 MG TABLET [Tenormin] ![Compare how all Medicare Part D PDP plans in OR cover ATENOLOL 100 MG TABLET [Tenormin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ATENOLOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover ATENOLOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ATENOLOL 50 MG TABLET [Tenormin] ![Compare how all Medicare Part D PDP plans in OR cover ATENOLOL 50 MG TABLET [Tenormin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in OR cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in OR cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ATOMOXETINE HCL 10 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 10 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATOMOXETINE HCL 100 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 100 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:30 /30Days |
ATOMOXETINE HCL 18 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 18 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ATOMOXETINE HCL 25 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 25 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ATOMOXETINE HCL 40 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 40 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:60 /30Days |
ATOMOXETINE HCL 60 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 60 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:30 /30Days |
ATOMOXETINE HCL 80 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in OR cover ATOMOXETINE HCL 80 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:30 /30Days |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in OR cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in OR cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in OR cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in OR cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in OR cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in OR cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
ATOVAQUONE-PROGUANIL 62.5-25 [Malarone] ![Compare how all Medicare Part D PDP plans in OR cover ATOVAQUONE-PROGUANIL 62.5-25 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in OR cover Atripla 600; 200; 300mg/1; mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ATROPINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in OR cover ATROPINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in OR cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | Q:26 /28Days |
AUBAGIO 14 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AUBAGIO 14 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AUBAGIO 7 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AUBAGIO 7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AUBRA-28 TABLET [Vienva] ![Compare how all Medicare Part D PDP plans in OR cover AUBRA-28 TABLET [Vienva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AUSTEDO 12 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AUSTEDO 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:120 /30Days |
AUSTEDO 6 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AUSTEDO 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
AUSTEDO 9 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AUSTEDO 9 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AVIANE 0.1-0.02 TABLET ![Compare how all Medicare Part D PDP plans in OR cover AVIANE 0.1-0.02 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AVONEX PEN 30 MCG/0.5 ML KIT ![Compare how all Medicare Part D PDP plans in OR cover AVONEX PEN 30 MCG/0.5 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:1 /28Days |
AVONEX PREFILLED SYR 30 MCG KT ![Compare how all Medicare Part D PDP plans in OR cover AVONEX PREFILLED SYR 30 MCG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:1 /28Days |
AYVAKIT 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AYVAKIT 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AYVAKIT 200 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AYVAKIT 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AYVAKIT 300 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AYVAKIT 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
AZATHIOPRINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AZATHIOPRINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | P |
AZELASTINE 0.15% NASAL SPRAY ![Compare how all Medicare Part D PDP plans in OR cover AZELASTINE 0.15% NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | Q:30 /25Days |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in OR cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | Q:30 /25Days |
AZELASTINE HCL 0.05% EYE DROPS [Optivar] ![Compare how all Medicare Part D PDP plans in OR cover AZELASTINE HCL 0.05% EYE DROPS [Optivar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AZITHROMYCIN 1 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 1 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZITHROMYCIN 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $150.00 | None |
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [Zithromax] ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [Zithromax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AZITHROMYCIN 250 MG TABLET [Zithromax Z-Pak] ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 250 MG TABLET [Zithromax Z-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AZITHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak] ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AZITHROMYCIN 600 MG TABLET [Zithromax Z-Pak] ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN 600 MG TABLET [Zithromax Z-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$4.00 | $8.00 | None |
AZITHROMYCIN I.V. 500 MG VIAL ![Compare how all Medicare Part D PDP plans in OR cover AZITHROMYCIN I.V. 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |
AZOPT 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in OR cover AZOPT 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$35.00 | $70.00 | None |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in OR cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$10.00 | $20.00 | None |