2021 Medicare Part D Plan Formulary Information |
Network Health Medicare Go (PPO) (H5215-009-0)
Benefit Details
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The Network Health Medicare Go (PPO) (H5215-009-0) Formulary Drugs Starting with the Letter R in Waukesha County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $0.00 Deductible: $275 |
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
RABAVERT RABIES VACCINE VIAL ![Compare how all Medicare Part D PDP plans in WI cover RABAVERT RABIES VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RABEPRAZOLE SOD DR 20 MG TABLET DR [AcipHex] ![Compare how all Medicare Part D PDP plans in WI cover RABEPRAZOLE SOD DR 20 MG TABLET DR [AcipHex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RALOXIFENE HCL 60 MG TABLET [Evista] ![Compare how all Medicare Part D PDP plans in WI cover RALOXIFENE HCL 60 MG TABLET [Evista].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RAMELTEON 8 MG TABLET [Rozerem] ![Compare how all Medicare Part D PDP plans in WI cover RAMELTEON 8 MG TABLET [Rozerem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RAMIPRIL 1.25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 1.25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
RAMIPRIL 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
RAMIPRIL 2.5 MG CAPSULE [Altace] ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 2.5 MG CAPSULE [Altace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
RAMIPRIL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
RANEXA ER 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RANEXA ER 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RANEXA ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RANEXA ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RANOLAZINE ER 1,000 MG TABLET 12H [Ranexa] ![Compare how all Medicare Part D PDP plans in WI cover RANOLAZINE ER 1,000 MG TABLET 12H [Ranexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RANOLAZINE ER 500 MG TABLET 12H [Ranexa] ![Compare how all Medicare Part D PDP plans in WI cover RANOLAZINE ER 500 MG TABLET 12H [Ranexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RAPAFLO 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAPAFLO 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RAPAFLO 8 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAPAFLO 8 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RAPAMUNE 0.5MG TABLETS ![Compare how all Medicare Part D PDP plans in WI cover RAPAMUNE 0.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P |
RAPAMUNE 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RAPAMUNE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in WI cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RAPAMUNE 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RAPAMUNE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RASAGILINE MESYLATE 0.5 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in WI cover RASAGILINE MESYLATE 0.5 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RASAGILINE MESYLATE 1 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in WI cover RASAGILINE MESYLATE 1 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RASUVO 10 MG/0.2 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 10 MG/0.2 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RASUVO 12.5 MG/0.25 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 12.5 MG/0.25 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 15 MG/0.3 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 15 MG/0.3 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 17.5 MG/0.35 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 17.5 MG/0.35 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 20 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 20 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 22.5 MG/0.45 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 22.5 MG/0.45 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 25 MG/0.5 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 25 MG/0.5 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 30 MG/0.6 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 30 MG/0.6 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RASUVO 7.5 MG/0.15 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 7.5 MG/0.15 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RAVICTI 1.1 GRAM/ML LIQUID ![Compare how all Medicare Part D PDP plans in WI cover RAVICTI 1.1 GRAM/ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:525 /30Days |
RAYALDEE ER 30 MCG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAYALDEE ER 30 MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:60 /30Days |
RAZADYNE ER 16MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAZADYNE ER 16MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RAZADYNE ER 24MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAZADYNE ER 24MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
RAZADYNE ER 8MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAZADYNE ER 8MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REBIF REBIDOSE 22 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE 22 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REBIF REBIDOSE 44 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE 44 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REBIF REBIDOSE TITRATION PACK ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE TITRATION PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in WI cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RECLIPSEN 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WI cover RECLIPSEN 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RECOMBIVAX HB 10 MCG/ML SYR ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 10 MCG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P |
RECOMBIVAX HB 10 MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 10 MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P |
RECTIV 0.4% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover RECTIV 0.4% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
REDITREX 10 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 10 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 12.5 MG/0.5 ML SYRING SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 12.5 MG/0.5 ML SYRING SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 15 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 15 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 17.5 MG/0.7 ML SYRING SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 17.5 MG/0.7 ML SYRING SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 20 MG/0.8 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 20 MG/0.8 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 22.5 MG/0.9 ML SYRING SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 22.5 MG/0.9 ML SYRING SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 25 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 25 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REDITREX 7.5 MG/0.3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 7.5 MG/0.3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REGLAN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REGLAN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REGLAN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REGLAN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in WI cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELAFEN DS 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RELAFEN DS 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in WI cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RELEXXII ER 72 MG TABLET ER 24 ![Compare how all Medicare Part D PDP plans in WI cover RELEXXII ER 72 MG TABLET ER 24.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RELISTOR 12 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 12 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELISTOR 12 MG/0.6 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 12 MG/0.6 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELISTOR 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELISTOR 8 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover RELISTOR 8 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELPAX 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RELPAX 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S Q:9 /30Days |
RELPAX 40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RELPAX 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S Q:9 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RELTONE 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RELTONE 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RELTONE 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RELTONE 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REMERON 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REMERON 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REMERON 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REMERON 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REMERON SLTABLET 15MG TABLET 30 BLPK CRTN ![Compare how all Medicare Part D PDP plans in WI cover REMERON SLTABLET 15MG TABLET 30 BLPK CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REMERON SLTABLET 30MG TABLET 30 TABLET S CRTN ![Compare how all Medicare Part D PDP plans in WI cover REMERON SLTABLET 30MG TABLET 30 TABLET S CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REMERON SLTABLET 45MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REMERON SLTABLET 45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RENAGEL 800MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RENAGEL 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REPAGLINIDE 0.5 MG TABLET [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover REPAGLINIDE 0.5 MG TABLET [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:960 /30Days |
REPAGLINIDE 1 MG TABLET [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover REPAGLINIDE 1 MG TABLET [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:480 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REPAGLINIDE 2 MG TABLET [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover REPAGLINIDE 2 MG TABLET [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:240 /30Days |
REPATHA 140 MG/ML SURECLICK PEN INJCTR ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 140 MG/ML SURECLICK PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:3 /30Days |
REPATHA 140 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 140 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:3 /30Days |
REPATHA 420 MG/3.5ML PUSHTRONX WEAR INJCT ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 420 MG/3.5ML PUSHTRONX WEAR INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:4 /28Days |
RESTASIS 0.05% EYE EMULSION ![Compare how all Medicare Part D PDP plans in WI cover RESTASIS 0.05% EYE EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RESTORIL 15mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RESTORIL 15mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RESTORIL 22.5mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RESTORIL 22.5mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RESTORIL 30mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RESTORIL 30mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RESTORIL 7.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RESTORIL 7.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RETACRIT 10,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 10,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:12 /28Days |
RETACRIT 2,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 2,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P Q:12 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RETACRIT 20,000 UNIT/2 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 20,000 UNIT/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:12 /28Days |
RETACRIT 20,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 20,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RETACRIT 3,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 3,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P Q:12 /28Days |
RETACRIT 4,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 4,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P Q:12 /28Days |
RETACRIT 40,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 40,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RETEVMO 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RETEVMO 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RETEVMO 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RETEVMO 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RETIN-A 0.01% GEL ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RETIN-A 0.025% GEL ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A 0.025% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RETIN-A 0.1% CREAM (g) ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A 0.1% CREAM (g).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RETIN-A MICRO 0.04% GEL ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A MICRO 0.04% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RETIN-A MICRO 0.1% GEL ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A MICRO 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RETIN-A MICRO PUMP 0.06% GEL ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A MICRO PUMP 0.06% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RETIN-A MICRO PUMP 0.08% GEL ![Compare how all Medicare Part D PDP plans in WI cover RETIN-A MICRO PUMP 0.08% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RETROVIR 100mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RETROVIR 100mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RETROVIR 50mg/5mL 240 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RETROVIR 50mg/5mL 240 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
REVATIO 10 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover REVATIO 10 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
REVATIO 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REVATIO 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
REVLIMID 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:28 /28Days |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:28 /28Days |
REVLIMID 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:28 /28Days |
REVLIMID 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVLIMID 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:28 /28Days |
REVLIMID 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:28 /28Days |
REXULTI 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
REXULTI 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
REXULTI 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
REXULTI 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
REXULTI 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
REXULTI 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REYATAZ 50 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 50 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
REYVOW 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REYVOW 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:8 /30Days |
REYVOW 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REYVOW 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:8 /30Days |
RHOFADE 1% CREAM (G) ![Compare how all Medicare Part D PDP plans in WI cover RHOFADE 1% CREAM (G).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RHOPRESSA 0.02% OPHTH SOLUTION Drops ![Compare how all Medicare Part D PDP plans in WI cover RHOPRESSA 0.02% OPHTH SOLUTION Drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
RIBAVIRIN 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIBAVIRIN 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIBAVIRIN 200 MG TABLET [Ribasphere] ![Compare how all Medicare Part D PDP plans in WI cover RIBAVIRIN 200 MG TABLET [Ribasphere].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIDAURA 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIDAURA 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RIFABUTIN 150 MG CAPSULE [Mycobutin] ![Compare how all Medicare Part D PDP plans in WI cover RIFABUTIN 150 MG CAPSULE [Mycobutin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RIFAMPIN 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIFAMPIN 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIFAMPIN IV 600 MG VIAL [Rifadin] ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN IV 600 MG VIAL [Rifadin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RILUTEK 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RILUTEK 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RILUZOLE 50 MG TABLET [Rilutek] ![Compare how all Medicare Part D PDP plans in WI cover RILUZOLE 50 MG TABLET [Rilutek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P |
Rimantadine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Rimantadine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RINVOQ ER 15 MG TABLET ER 24H ![Compare how all Medicare Part D PDP plans in WI cover RINVOQ ER 15 MG TABLET ER 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RIOMET 500MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in WI cover RIOMET 500MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:765 /30Days |
RISEDRONATE SODIUM 150 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 150 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:1 /30Days |
RISEDRONATE SODIUM 30 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 30 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:5 /30Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:5 /30Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:5 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISEDRONATE SODIUM 5 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 5 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:30 /30Days |
RISEDRONATE SODIUM DR 35 MG TABLET DR [Atelvia] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM DR 35 MG TABLET DR [Atelvia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:5 /30Days |
RISPERDAL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERDAL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERDAL 1MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL 1MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERDAL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERDAL 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERDAL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
RISPERIDONE 0.25 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.25 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 0.5 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.5 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 1 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 1 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 2 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 2 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE 3 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 3 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERIDONE 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE 4 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 4 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RISPERIDONE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RITALIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RITALIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITALIN 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RITALIN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITALIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RITALIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITALIN LA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RITALIN LA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITALIN LA 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RITALIN LA 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITALIN LA 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RITALIN LA 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITALIN LA 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RITALIN LA 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RITONAVIR 100 MG TABLET [Norvir] ![Compare how all Medicare Part D PDP plans in WI cover RITONAVIR 100 MG TABLET [Norvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIVASTIGMINE 1.5 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 1.5 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVASTIGMINE 13.3 MG/24HR PTCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 13.3 MG/24HR PTCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVASTIGMINE 3 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 3 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVASTIGMINE 4.5 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 4.5 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVASTIGMINE 4.6 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 4.6 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVASTIGMINE 6 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 6 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVASTIGMINE 9.5 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 9.5 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
RIVELSA TABLET TBDSPK 3MO ![Compare how all Medicare Part D PDP plans in WI cover RIVELSA TABLET TBDSPK 3MO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RIZATRIPTAN 10 MG ODT [Maxalt-MLT] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 10 MG ODT [Maxalt-MLT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:36 /28Days |
RIZATRIPTAN 10 MG TABLET [Maxalt] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 10 MG TABLET [Maxalt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:36 /28Days |
RIZATRIPTAN 5 MG ODT TABLET RAPDIS [Maxalt-MLT] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 5 MG ODT TABLET RAPDIS [Maxalt-MLT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:36 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIZATRIPTAN 5 MG TABLET [Maxalt] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 5 MG TABLET [Maxalt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:36 /28Days |
Rocaltrol 0.25ug GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Rocaltrol 0.25ug GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Rocaltrol 0.5ug GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Rocaltrol 0.5ug GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Rocaltrol 1ug/mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Rocaltrol 1ug/mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
ROCKLATAN 0.02%-0.005% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ROCKLATAN 0.02%-0.005% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
ROPINIROLE HCL 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL 1 MG TABLET [Requip] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 1 MG TABLET [Requip].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL 2 MG TABLET [Requip] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 2 MG TABLET [Requip].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL ER 12 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 12 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
ROPINIROLE HCL ER 2 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 2 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL ER 4 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 4 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL ER 6 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 6 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROPINIROLE HCL ER 8 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 8 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ROSUVASTATIN CALCIUM 40 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 40 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
ROTARIX VACCINE SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover ROTARIX VACCINE SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROTATEQ VACCINE SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ROTATEQ VACCINE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
Rowasa Rectal 4 G 60 ml Kit 28X60 ![Compare how all Medicare Part D PDP plans in WI cover Rowasa Rectal 4 G 60 ml Kit 28X60.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
ROWEEPRA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROWEEPRA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
ROXICODONE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROXICODONE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:180 /30Days |
ROXICODONE 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROXICODONE 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:180 /30Days |
ROXICODONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROXICODONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:360 /30Days |
ROZEREM 8 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROZEREM 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
ROZLYTREK 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ROZLYTREK 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
ROZLYTREK 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ROZLYTREK 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RUBRACA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
RUBRACA 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RUBRACA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
RUCONEST 2,100 UNIT VIAL ![Compare how all Medicare Part D PDP plans in WI cover RUCONEST 2,100 UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RUFINAMIDE 40 MG/ML ORAL SUSPENSION [Banzel] ![Compare how all Medicare Part D PDP plans in WI cover RUFINAMIDE 40 MG/ML ORAL SUSPENSION [Banzel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
RUKOBIA ER 600 MG TABLETLET ER 12H ![Compare how all Medicare Part D PDP plans in WI cover RUKOBIA ER 600 MG TABLETLET ER 12H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
RUZURGI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUZURGI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
RYBELSUS 14 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYBELSUS 14 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | S Q:30 /30Days |
RYBELSUS 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYBELSUS 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | S Q:30 /30Days |
RYBELSUS 7 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYBELSUS 7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | S Q:30 /30Days |
RYCLORA 2 MG/5 ML SOLUTION SYRUP ![Compare how all Medicare Part D PDP plans in WI cover RYCLORA 2 MG/5 ML SOLUTION SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYDAPT 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RYDAPT 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:240 /30Days |
RYTARY ER 23.75 MG-95 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 23.75 MG-95 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RYTARY ER 36.25 MG-145 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 36.25 MG-145 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYTARY ER 48.75 MG-195 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 48.75 MG-195 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYTARY ER 61.25 MG-245 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 61.25 MG-245 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYTHMOL SR 225mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RYTHMOL SR 225mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYTHMOL SR 325mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RYTHMOL SR 325mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYTHMOL SR 425mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover RYTHMOL SR 425mg/1 60 CAPSULE, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
RYVENT 6 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYVENT 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |