2021 Medicare Part D Plan Formulary Information |
Network PlatinumChoice (PPO) (H5215-011-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Network PlatinumChoice (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Network PlatinumChoice (PPO) (H5215-011-0) Formulary Drugs Starting with the Letter V in Manitowoc County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $31.00 Deductible: $260 |
Drugs Starting with Letter V
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
VABOMERE 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in WI cover VABOMERE 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VAGIFEM 10 MCG VAGINAL TABLET ![Compare how all Medicare Part D PDP plans in WI cover VAGIFEM 10 MCG VAGINAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VALACYCLOVIR HCL 1 GRAM TABLET [Valtrex] ![Compare how all Medicare Part D PDP plans in WI cover VALACYCLOVIR HCL 1 GRAM TABLET [Valtrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:120 /30Days |
VALACYCLOVIR HCL 500 MG TABLET [Valtrex] ![Compare how all Medicare Part D PDP plans in WI cover VALACYCLOVIR HCL 500 MG TABLET [Valtrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | Q:60 /30Days |
VALCHLOR 0.016% GEL ![Compare how all Medicare Part D PDP plans in WI cover VALCHLOR 0.016% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VALCYTE 450MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VALCYTE 450MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:120 /30Days |
VALCYTE FOR ORAL SOLUTION 50MG/ML ![Compare how all Medicare Part D PDP plans in WI cover VALCYTE FOR ORAL SOLUTION 50MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:1080 /30Days |
VALGANCICLOVIR 450 MG TABLET [Valcyte] ![Compare how all Medicare Part D PDP plans in WI cover VALGANCICLOVIR 450 MG TABLET [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:120 /30Days |
VALGANCICLOVIR HCL 50 MG/ML [Valcyte] ![Compare how all Medicare Part D PDP plans in WI cover VALGANCICLOVIR HCL 50 MG/ML [Valcyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:1080 /30Days |
VALIUM 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VALIUM 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 |
Valium 2mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Valium 2mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VALPROIC ACID 250 MG CAPSULE [Depakene] ![Compare how all Medicare Part D PDP plans in WI cover VALPROIC ACID 250 MG CAPSULE [Depakene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALPROIC ACID 250 MG/5 ML SOLUTION [Depakene] ![Compare how all Medicare Part D PDP plans in WI cover VALPROIC ACID 250 MG/5 ML SOLUTION [Depakene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALSARTAN 160 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 160 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
VALSARTAN 320 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 320 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALSARTAN 40 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 40 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
VALSARTAN 80 MG TABLET [Diovan] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN 80 MG TABLET [Diovan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALSARTAN-HCTZ 160-25 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 160-25 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALSARTAN-HCTZ 320-12.5 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 320-12.5 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALSARTAN-HCTZ 320-25 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 320-25 MG TABLET [Diovan HCT].](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 |
VALSARTAN-HCTZ 80-12.5 MG TABLET [Diovan HCT] ![Compare how all Medicare Part D PDP plans in WI cover VALSARTAN-HCTZ 80-12.5 MG TABLET [Diovan HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VALTOCO 10 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WI cover VALTOCO 10 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VALTOCO 15 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WI cover VALTOCO 15 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VALTOCO 20 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WI cover VALTOCO 20 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VALTOCO 5 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WI cover VALTOCO 5 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VALTREX 1 GM CAPLET ![Compare how all Medicare Part D PDP plans in WI cover VALTREX 1 GM CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:120 /30Days |
VALTREX 500 MG CAPLET ![Compare how all Medicare Part D PDP plans in WI cover VALTREX 500 MG CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:60 /30Days |
VANCOCIN HCL 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VANCOCIN HCL 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VANCOCIN HCL 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VANCOCIN HCL 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VANCOMYCIN 1 GM VIAL [Vancocin] ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN 1 GM VIAL [Vancocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VANCOMYCIN 250 MG/5 ML SOLUTION RECON [Vancocin] ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN 250 MG/5 ML SOLUTION RECON [Vancocin].](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 |
VANCOMYCIN 500 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VANCOMYCIN HCL 125 MG CAPSULE [Vancocin] ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 125 MG CAPSULE [Vancocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VANCOMYCIN HCL 250 MG CAPSULE [Vancocin] ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 250 MG CAPSULE [Vancocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VANCOMYCIN HCL 250 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 250 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VANCOMYCIN HCL 750 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HCL 750 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA ![Compare how all Medicare Part D PDP plans in WI cover VANCOMYCIN HYDROCHLORIDE 100MG/ML 1 VIAL, PHARMACY BULK PACKAGE in 1 CASE / 95 mL in 1 VIAL, PHARMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VANDAZOLE 0.75% GEL WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in WI cover VANDAZOLE 0.75% GEL WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VANOS 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover VANOS 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VAQTA 25 UNITS/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover VAQTA 25 UNITS/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VAQTA 50 UNITS/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover VAQTA 50 UNITS/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VAQTA 50 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover VAQTA 50 UNITS/ML VIAL.](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 |
Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL ![Compare how all Medicare Part D PDP plans in WI cover Vaqta Hepatitis A Vaccine Pediatric / Adolescent 25 Unit / 0.5 mL Injection Single Dose Vial 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VARIVAX VACCINE W/DILUENT ![Compare how all Medicare Part D PDP plans in WI cover VARIVAX VACCINE W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VARIZIG 125 UNIT/1.2 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover VARIZIG 125 UNIT/1.2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VARUBI 90 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VARUBI 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P Q:4 /28Days |
VASCEPA 0.5 GM CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VASCEPA 0.5 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VASCEPA 1 GM CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VASCEPA 1 GM CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VASERETIC 10-25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VASERETIC 10-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VASOTEC 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VASOTEC 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VASOTEC 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VASOTEC 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VECAMYL 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VECAMYL 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VECTICAL OINTMENT 3MCG/GM 100 GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover VECTICAL OINTMENT 3MCG/GM 100 GM TUBE.](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 |
VELIVET 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in WI cover VELIVET 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VELPHORO 500 MG CHEWABLE TAB ![Compare how all Medicare Part D PDP plans in WI cover VELPHORO 500 MG CHEWABLE TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VELTASSA 16.8 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover VELTASSA 16.8 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VELTASSA 25.2 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover VELTASSA 25.2 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VELTASSA 8.4 GM POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover VELTASSA 8.4 GM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VELTIN 1.2%-0.025% GEL ![Compare how all Medicare Part D PDP plans in WI cover VELTIN 1.2%-0.025% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
VEMLIDY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VEMLIDY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:30 /30Days |
VENCLEXTA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P Q:60 /30Days |
VENCLEXTA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
VENCLEXTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:30 /30Days |
VENCLEXTA STARTING PACK ![Compare how all Medicare Part D PDP plans in WI cover VENCLEXTA STARTING PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VENLAFAXINE HCL 100 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 100 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL 25 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 25 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL 37.5 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 37.5 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL 50 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 50 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL 75 MG TABLET [Effexor] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL 75 MG TABLET [Effexor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL ER 150 MG CAPSULE ER 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 150 MG CAPSULE ER 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL ER 150 MG TABLET ER 24 [Venlafaxine] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 150 MG TABLET ER 24 [Venlafaxine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VENLAFAXINE HCL ER 225 MG TABLET ER 24 [Venlafaxine] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 225 MG TABLET ER 24 [Venlafaxine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VENLAFAXINE HCL ER 37.5 MG CAPSULE ER 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 37.5 MG CAPSULE ER 24H [Effexor XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VENLAFAXINE HCL ER 37.5 MG TABLET ER 24 [Venlafaxine] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 37.5 MG TABLET ER 24 [Venlafaxine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VENLAFAXINE HCL ER 75 MG CAPSULE ER 24H [Effexor XR] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 75 MG CAPSULE ER 24H [Effexor XR].](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 |
VENLAFAXINE HCL ER 75 MG TABLET ER 24 [Venlafaxine] ![Compare how all Medicare Part D PDP plans in WI cover VENLAFAXINE HCL ER 75 MG TABLET ER 24 [Venlafaxine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
Ventavis 0.02mg/mL ![Compare how all Medicare Part D PDP plans in WI cover Ventavis 0.02mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:90 /30Days |
VENTAVIS 10 MCG/1 ML SOLUTION AMPUL-NEB ![Compare how all Medicare Part D PDP plans in WI cover VENTAVIS 10 MCG/1 ML SOLUTION AMPUL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:210 /30Days |
VENTOLIN HFA 90MCG INHALER ![Compare how all Medicare Part D PDP plans in WI cover VENTOLIN HFA 90MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:36 /30Days |
VERAPAMIL 120 MG TABLET [Calan] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 120 MG TABLET [Calan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL 40 MG TABLET [Isoptin SR] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 40 MG TABLET [Isoptin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL 80 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL ER 120 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL ER 180 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL ER 240 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER 240 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL ER PM 100 MG CAPSULE 24H PCT [Verelan PM] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER PM 100 MG CAPSULE 24H PCT [Verelan PM].](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 |
VERAPAMIL ER PM 200 MG CAPSULE 24H PCT [Verelan PM] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER PM 200 MG CAPSULE 24H PCT [Verelan PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VERAPAMIL ER PM 300 MG CAPSULE 24H PCT [Verelan PM] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL ER PM 300 MG CAPSULE 24H PCT [Verelan PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL HCL 360MG CAPSULES SUSTAINED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL SR 120 MG CAPSULE 24H PEL [Verelan] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL SR 120 MG CAPSULE 24H PEL [Verelan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL SR 180 MG CAPSULE 24H PEL [Verelan] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL SR 180 MG CAPSULE 24H PEL [Verelan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERAPAMIL SR 240 MG CAPSULE 24H PEL [Verelan] ![Compare how all Medicare Part D PDP plans in WI cover VERAPAMIL SR 240 MG CAPSULE 24H PEL [Verelan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VERDESO 0.05% FOAM ![Compare how all Medicare Part D PDP plans in WI cover VERDESO 0.05% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VEREGEN 15% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover VEREGEN 15% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERELAN 120 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN 120 MG CAPSULE PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERELAN 180 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN 180 MG CAPSULE PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERELAN 240 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN 240 MG CAPSULE PELLET.](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 |
VERELAN 360 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN 360 MG CAPSULE PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERELAN PM 100 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN PM 100 MG CAPSULE PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERELAN PM 200 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN PM 200 MG CAPSULE PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERELAN PM 300 MG CAPSULE PELLET ![Compare how all Medicare Part D PDP plans in WI cover VERELAN PM 300 MG CAPSULE PELLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERQUVO 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERQUVO 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERQUVO 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERQUVO 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERQUVO 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERQUVO 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VERSACLOZ 50 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover VERSACLOZ 50 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
VERZENIO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
VERZENIO 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
VERZENIO 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VERZENIO 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VERZENIO 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
VESICARE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VESICARE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VESICARE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VESICARE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VESICARE LS 5 MG/5 ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover VESICARE LS 5 MG/5 ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VESTURA 3 MG-0.02 MG TABLET [Yaz] ![Compare how all Medicare Part D PDP plans in WI cover VESTURA 3 MG-0.02 MG TABLET [Yaz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VFEND 200MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VFEND 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VFEND 40MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover VFEND 40MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VFEND 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VFEND 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VFEND IV 200MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover VFEND IV 200MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIBERZI 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIBERZI 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIBERZI 75 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIBERZI 75 MG TABLET.](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 |
VIBRAMYCIN 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VIBRAMYCIN 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIBRAMYCIN 25MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover VIBRAMYCIN 25MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIBRAMYCIN 50 MG/5 ML SYRUP ![Compare how all Medicare Part D PDP plans in WI cover VIBRAMYCIN 50 MG/5 ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VICTOZA 3-PAK 18 MG/3 ML PEN ![Compare how all Medicare Part D PDP plans in WI cover VICTOZA 3-PAK 18 MG/3 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | S Q:9 /30Days |
VIEKIRA PAK ![Compare how all Medicare Part D PDP plans in WI cover VIEKIRA PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
VIENVA-28 TABLET [Vienva] ![Compare how all Medicare Part D PDP plans in WI cover VIENVA-28 TABLET [Vienva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VIGABATRIN 50 MG/ML ORAL SOLUTION [SABRIL] ![Compare how all Medicare Part D PDP plans in WI cover VIGABATRIN 50 MG/ML ORAL SOLUTION [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:180 /30Days |
VIGABATRIN 500 MG ORAL TABLET [SABRIL] ![Compare how all Medicare Part D PDP plans in WI cover VIGABATRIN 500 MG ORAL TABLET [SABRIL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:180 /30Days |
VIGABATRIN 500 MG POWDER PACKET [VIGADRONE] ![Compare how all Medicare Part D PDP plans in WI cover VIGABATRIN 500 MG POWDER PACKET [VIGADRONE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:180 /30Days |
VIGABATRIN 500 MG TABLET [Sabril] ![Compare how all Medicare Part D PDP plans in WI cover VIGABATRIN 500 MG TABLET [Sabril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:180 /30Days |
VIGADRONE 500 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover VIGADRONE 500 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VIGAMOX 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover VIGAMOX 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIIBRYD 10-20 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 10-20 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 10mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 20mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover VIIBRYD 40mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VIMPAT 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover VIMPAT 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 100mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 150mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 200mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Vimpat 50mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
VIOKACE 10,440-39,150 UNIT TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIOKACE 10,440-39,150 UNIT 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 |
VIOKACE 20,880-78,300 UNIT TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIOKACE 20,880-78,300 UNIT TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIRACEPT 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIRACEPT 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIRACEPT 625MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIRACEPT 625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
Viramune 400mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Viramune 400mg/1 30 TABLET, 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 |
VIRAMUNE 50MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover VIRAMUNE 50MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIREAD 150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIREAD 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIREAD 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIREAD 300MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIREAD 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIREAD POWDER ![Compare how all Medicare Part D PDP plans in WI cover VIREAD POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VISTARIL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VISTARIL 25MG CAPSULE.](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 |
VISTARIL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VISTARIL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VITRAKVI 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VITRAKVI 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
VITRAKVI 20 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover VITRAKVI 20 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:300 /30Days |
VITRAKVI 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VITRAKVI 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:180 /30Days |
VIVELLE-DOT 0.025 MG PATCH ![Compare how all Medicare Part D PDP plans in WI cover VIVELLE-DOT 0.025 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIVELLE-DOT 0.0375MG PATCH 8 POUCH CRTN (1 X 8 POUCH CRTN) ![Compare how all Medicare Part D PDP plans in WI cover VIVELLE-DOT 0.0375MG PATCH 8 POUCH CRTN (1 X 8 POUCH CRTN).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIVELLE-DOT 0.05MG PATCH 8 POUCH CRTN (1X8 POUCH CRTN) ![Compare how all Medicare Part D PDP plans in WI cover VIVELLE-DOT 0.05MG PATCH 8 POUCH CRTN (1X8 POUCH CRTN).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIVELLE-DOT 0.075 MG PATCH ![Compare how all Medicare Part D PDP plans in WI cover VIVELLE-DOT 0.075 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIVELLE-DOT 0.1 MG PATCH ![Compare how all Medicare Part D PDP plans in WI cover VIVELLE-DOT 0.1 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIVITROL INJECTABLE SUSPENSION 380MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover VIVITROL INJECTABLE SUSPENSION 380MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VIVLODEX 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VIVLODEX 10 MG CAPSULE.](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 |
VIVLODEX 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VIVLODEX 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VIZIMPRO 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIZIMPRO 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:30 /30Days |
VIZIMPRO 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIZIMPRO 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:30 /30Days |
VIZIMPRO 45 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VIZIMPRO 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:30 /30Days |
VOGELXO 12.5 MG/1.25 GRAM PUMP ![Compare how all Medicare Part D PDP plans in WI cover VOGELXO 12.5 MG/1.25 GRAM PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
VOGELXO 50 MG/5 GRAM GEL ![Compare how all Medicare Part D PDP plans in WI cover VOGELXO 50 MG/5 GRAM GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | P |
VORICONAZOLE 200 MG TABLET [VFEND] ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 200 MG TABLET [VFEND].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VORICONAZOLE 200 MG VIAL [VFEND] ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 200 MG VIAL [VFEND].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VORICONAZOLE 40 MG/ML ORAL SUSPENSION [VFEND] ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 40 MG/ML ORAL SUSPENSION [VFEND].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VORICONAZOLE 50 MG TABLET [VFEND] ![Compare how all Medicare Part D PDP plans in WI cover VORICONAZOLE 50 MG TABLET [VFEND].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VOSEVI 400-100-100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VOSEVI 400-100-100 MG TABLET.](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 |
VOTRIENT 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VOTRIENT 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:120 /30Days |
VRAYLAR 1.5 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 1.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
VRAYLAR 1.5 MG-3 MG PACK ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 1.5 MG-3 MG PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |
VRAYLAR 3 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 3 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
VRAYLAR 4.5 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 4.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
VRAYLAR 6 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover VRAYLAR 6 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
VTOL LQ 50-325-40 MG/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover VTOL LQ 50-325-40 MG/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:5550 /30Days |
VUMERITY DR 231 MG CAPSULE DR ![Compare how all Medicare Part D PDP plans in WI cover VUMERITY DR 231 MG CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
VYFEMLA 0.4 MG-0.035 MG TABLET [Zenchent] ![Compare how all Medicare Part D PDP plans in WI cover VYFEMLA 0.4 MG-0.035 MG TABLET [Zenchent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VYLIBRA 28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYLIBRA 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $20.00 | None |
VYNDAMAX 61 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYNDAMAX 61 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
VYNDAQEL 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYNDAQEL 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
VYTORIN 10-10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VYTORIN 10-20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VYTORIN 10-40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VYTORIN 10-80 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYTORIN 10-80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | None |
VYVANSE 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 10 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 10 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 20 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 20 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 30 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 30 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 40 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 40 MG CHEWABLE TABLET.](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 |
VYVANSE 40MG CAPSULE 100 EA ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 40MG CAPSULE 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 50 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 50 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 60 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 60 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE 70MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE 70MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE CAPSULES 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE CAPSULES 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYVANSE CAPSULES 60MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover VYVANSE CAPSULES 60MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
VYZULTA 0.024% OPHTH SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover VYZULTA 0.024% OPHTH SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $225.00 | S |