2021 Medicare Part D Plan Formulary Information |
Triple S Platino Alcance (HMO D-SNP) (H5774-035-0)
Benefit Details
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The Triple S Platino Alcance (HMO D-SNP) (H5774-035-0) Formulary Drugs Starting with the Letter A in Corozal County, PR: CMS MA Region 30 which includes: PR Plan Monthly Premium: $0.00 Deductible: $445 |
Drugs Starting with Letter A
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ABACAVIR 20 MG/ML SOLUTION [Ziagen] ![Compare how all Medicare Part D PDP plans in PR cover ABACAVIR 20 MG/ML SOLUTION [Ziagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ABACAVIR 300 MG TABLET [Ziagen] ![Compare how all Medicare Part D PDP plans in PR cover ABACAVIR 300 MG TABLET [Ziagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir] ![Compare how all Medicare Part D PDP plans in PR cover Abacavir Sulfate-Lamivudine-Zidovudine tablets [Trizivir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ABACAVIR-LAMIVUDINE 600-300 MG TABLET [Epzicom] ![Compare how all Medicare Part D PDP plans in PR cover ABACAVIR-LAMIVUDINE 600-300 MG TABLET [Epzicom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ABELCET INJECTION SUSPENSION 5MG/ML ![Compare how all Medicare Part D PDP plans in PR cover ABELCET INJECTION SUSPENSION 5MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
ABILIFY MAINTENA ER 300 MG SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 300 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
ABILIFY MAINTENA ER 300 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 300 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
ABILIFY MAINTENA ER 400 MG SUSER VIAL ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 400 MG SUSER VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
ABILIFY MAINTENA ER 400 MG SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ABILIFY MAINTENA ER 400 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
ABIRATERONE 500 MG TABLET [ZYTIGA] ![Compare how all Medicare Part D PDP plans in PR cover ABIRATERONE 500 MG TABLET [ZYTIGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ABIRATERONE ACETATE 250 MG TABLET [ZYTIGA] ![Compare how all Medicare Part D PDP plans in PR cover ABIRATERONE ACETATE 250 MG TABLET [ZYTIGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
Acamprosate Calcium DR 333 MG tablets [Campral] ![Compare how all Medicare Part D PDP plans in PR cover Acamprosate Calcium DR 333 MG tablets [Campral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACARBOSE 100 MG TABLET [Precose] ![Compare how all Medicare Part D PDP plans in PR cover ACARBOSE 100 MG TABLET [Precose].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACARBOSE 25 MG TABLET [Precose] ![Compare how all Medicare Part D PDP plans in PR cover ACARBOSE 25 MG TABLET [Precose].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACARBOSE 50 MG TABLET [Precose] ![Compare how all Medicare Part D PDP plans in PR cover ACARBOSE 50 MG TABLET [Precose].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACEBUTOLOL 200 MG CAPSULE [Sectral] ![Compare how all Medicare Part D PDP plans in PR cover ACEBUTOLOL 200 MG CAPSULE [Sectral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACEBUTOLOL 400 MG CAPSULE [Sectral] ![Compare how all Medicare Part D PDP plans in PR cover ACEBUTOLOL 400 MG CAPSULE [Sectral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACETAMINOP-CODEINE 120-12 MG/5 ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOP-CODEINE 120-12 MG/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:4500 /30Days |
ACETAMINOPHEN-COD #2 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOPHEN-COD #2 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3] ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:360 /30Days |
ACETAMINOPHEN-COD #4 TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACETAMINOPHEN-COD #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACETAZOLAMIDE 125MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACETAZOLAMIDE 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACETAZOLAMIDE 250 MG TABLET [Diamox] ![Compare how all Medicare Part D PDP plans in PR cover ACETAZOLAMIDE 250 MG TABLET [Diamox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACETIC ACID 2% EAR SOLUTION [VoSoL] ![Compare how all Medicare Part D PDP plans in PR cover ACETIC ACID 2% EAR SOLUTION [VoSoL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACETYLCYSTEINE 10% VIAL ![Compare how all Medicare Part D PDP plans in PR cover ACETYLCYSTEINE 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
ACETYLCYSTEINE 20% VIAL [Mucosil Acetylcysteine] ![Compare how all Medicare Part D PDP plans in PR cover ACETYLCYSTEINE 20% VIAL [Mucosil Acetylcysteine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | P |
ACITRETIN 10 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in PR cover ACITRETIN 10 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACITRETIN 17.5 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in PR cover ACITRETIN 17.5 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ACITRETIN 25 MG CAPSULE [Soriatane] ![Compare how all Medicare Part D PDP plans in PR cover ACITRETIN 25 MG CAPSULE [Soriatane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACTHIB VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in PR cover ACTHIB VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ACTIMMUNE 100 MCG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ACTIMMUNE 100 MCG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ACYCLOVIR 200 MG CAPSULE [Zovirax] ![Compare how all Medicare Part D PDP plans in PR cover ACYCLOVIR 200 MG CAPSULE [Zovirax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ACYCLOVIR 200 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover ACYCLOVIR 200 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACYCLOVIR 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACYCLOVIR 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ACYCLOVIR 5% OINTMENT [Zovirax] ![Compare how all Medicare Part D PDP plans in PR cover ACYCLOVIR 5% OINTMENT [Zovirax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ACYCLOVIR 800 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ACYCLOVIR 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
Acyclovir sodium 500 mg vial ![Compare how all Medicare Part D PDP plans in PR cover Acyclovir sodium 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
ADACEL TDAP SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ADACEL TDAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ADACEL VIAL 2UNT/5UNT ![Compare how all Medicare Part D PDP plans in PR cover ADACEL VIAL 2UNT/5UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ADAPALENE 0.1% CREAM (G) [Differin] ![Compare how all Medicare Part D PDP plans in PR cover ADAPALENE 0.1% CREAM (G) [Differin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ADAPALENE 0.3% GEL [Differin Pump] ![Compare how all Medicare Part D PDP plans in PR cover ADAPALENE 0.3% GEL [Differin Pump].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ADAPALENE-BNZYL PEROX 0.1-2.5% GEL W/PUMP [Epiduo] ![Compare how all Medicare Part D PDP plans in PR cover ADAPALENE-BNZYL PEROX 0.1-2.5% GEL W/PUMP [Epiduo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
ADEFOVIR DIPIVOXIL 10 MG TABLET [Hepsera] ![Compare how all Medicare Part D PDP plans in PR cover ADEFOVIR DIPIVOXIL 10 MG TABLET [Hepsera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ADEMPAS 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ADEMPAS 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ADEMPAS 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ADEMPAS 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ADEMPAS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ADEMPAS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:12 /30Days |
ADVAIR HFA INHALER 115;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR HFA INHALER 115;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:12 /30Days |
ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL ![Compare how all Medicare Part D PDP plans in PR cover ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:12 /30Days |
AFINITOR 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:60 /30Days |
AFINITOR DISPERZ 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR DISPERZ 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:300 /30Days |
AFINITOR DISPERZ 3 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR DISPERZ 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AFINITOR DISPERZ 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AFINITOR DISPERZ 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
ALBENDAZOLE 200 MG TABLET [Albenza] ![Compare how all Medicare Part D PDP plans in PR cover ALBENDAZOLE 200 MG TABLET [Albenza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ALBUTEROL 2.5 MG/0.5 ML SOL VIAL-NEB ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL 2.5 MG/0.5 ML SOL VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:60 /30Days |
ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA] ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:36 /30Days |
ALBUTEROL SUL 0.63 MG/3 ML SOL VIAL-NEB ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SUL 0.63 MG/3 ML SOL VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:360 /30Days |
ALBUTEROL SUL 1.25 MG/3 ML SOL VIAL-NEB ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SUL 1.25 MG/3 ML SOL VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:360 /30Days |
ALBUTEROL SUL 2.5 MG/3 ML SOLUTION VIAL-NEB ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SUL 2.5 MG/3 ML SOLUTION VIAL-NEB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | P Q:360 /30Days |
ALBUTEROL SULF 2 MG/5 ML SYRUP ![Compare how all Medicare Part D PDP plans in PR cover ALBUTEROL SULF 2 MG/5 ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ALECENSA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover ALECENSA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ALENDRONATE SODIUM 10 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 10 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ALENDRONATE SODIUM 35 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 35 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALENDRONATE SODIUM 70 MG TABLET [Fosamax] ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 70 MG TABLET [Fosamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:4 /28Days |
ALENDRONATE SODIUM 70 MG/75 ML ![Compare how all Medicare Part D PDP plans in PR cover ALENDRONATE SODIUM 70 MG/75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ALFUZOSIN HCL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALFUZOSIN HCL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ALINIA 100 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in PR cover ALINIA 100 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None |
ALISKIREN 150 MG TABLET [Tekturna] ![Compare how all Medicare Part D PDP plans in PR cover ALISKIREN 150 MG TABLET [Tekturna].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
ALISKIREN 300 MG TABLET [Tekturna] ![Compare how all Medicare Part D PDP plans in PR cover ALISKIREN 300 MG TABLET [Tekturna].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
ALLOPURINOL 100 MG TABLET [Zyloprim] ![Compare how all Medicare Part D PDP plans in PR cover ALLOPURINOL 100 MG TABLET [Zyloprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ALLOPURINOL 300 MG TABLET [Zyloprim] ![Compare how all Medicare Part D PDP plans in PR cover ALLOPURINOL 300 MG TABLET [Zyloprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ALPHAGAN P 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover ALPHAGAN P 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ALPRAZOLAM 0.25 MG TABLET [Xanax] ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 0.25 MG TABLET [Xanax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:120 /30Days |
ALPRAZOLAM 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ALPRAZOLAM 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:120 /30Days |
ALPRAZOLAM 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALPRAZOLAM 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:150 /30Days |
ALUNBRIG 180 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALUNBRIG 180 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ALUNBRIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALUNBRIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ALUNBRIG 90 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ALUNBRIG 90 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ALUNBRIG 90 MG-180 MG TABLET PACK ![Compare how all Medicare Part D PDP plans in PR cover ALUNBRIG 90 MG-180 MG TABLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
AMANTADINE 100 MG CAPSULE [Symmetrel] ![Compare how all Medicare Part D PDP plans in PR cover AMANTADINE 100 MG CAPSULE [Symmetrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMANTADINE 50 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMANTADINE 50 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMIKACIN SULF 500 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMIKACIN SULF 500 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
AMILORIDE HCL 5 MG TABLET [Midamor] ![Compare how all Medicare Part D PDP plans in PR cover AMILORIDE HCL 5 MG TABLET [Midamor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMILORIDE HCL-HCTZ 5-50 MG TABLET [Moduretic] ![Compare how all Medicare Part D PDP plans in PR cover AMILORIDE HCL-HCTZ 5-50 MG TABLET [Moduretic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10] ![Compare how all Medicare Part D PDP plans in PR cover Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5] ![Compare how all Medicare Part D PDP plans in PR cover Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
AMINOSYN II 15% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN II 15% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
AMINOSYN-PF 7% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PR cover AMINOSYN-PF 7% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
AMIODARONE HCL 100 MG TABLET [Pacerone] ![Compare how all Medicare Part D PDP plans in PR cover AMIODARONE HCL 100 MG TABLET [Pacerone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMIODARONE HCL 200 MG TABLET [Pacerone] ![Compare how all Medicare Part D PDP plans in PR cover AMIODARONE HCL 200 MG TABLET [Pacerone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMIODARONE HCL 400 MG TABLET [Pacerone] ![Compare how all Medicare Part D PDP plans in PR cover AMIODARONE HCL 400 MG TABLET [Pacerone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMITIZA 24 MCG 60 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover AMITIZA 24 MCG 60 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
AMITIZA 8MCG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover AMITIZA 8MCG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
AMITRIPTYLINE HCL 10 MG TABLET [Elavil] ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 10 MG TABLET [Elavil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMITRIPTYLINE HCL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMITRIPTYLINE HCL 75 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMITRIPTYLINE HCL 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMLODIPINE BESYLATE 10 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE 10 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:30 /30Days |
AMLODIPINE BESYLATE 2.5 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE 2.5 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:30 /30Days |
AMLODIPINE BESYLATE 5 MG TABLET [Norvasc] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE BESYLATE 5 MG TABLET [Norvasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | Q:60 /30Days |
AMLODIPINE-ATORVAST 10-20 MG [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-ATORVAST 10-20 MG [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMLODIPINE-ATORVAST 10-40 MG [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-ATORVAST 10-40 MG [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 10-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 10-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 10-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 10-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Amlodipine-Atorvastatin 2.5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 2.5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 2.5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 2.5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 2.5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 2.5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 5-10 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-10 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 5-20 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-20 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 5-40 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-40 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Amlodipine-Atorvastatin 5-80 mg [Caduet] ![Compare how all Medicare Part D PDP plans in PR cover Amlodipine-Atorvastatin 5-80 mg [Caduet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMLODIPINE-BENAZEPRIL 10-20 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 10-20 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMLODIPINE-BENAZEPRIL 10-40 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 10-40 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMLODIPINE-BENAZEPRIL 2.5-10 CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 2.5-10 CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMLODIPINE-BENAZEPRIL 5-10 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 5-10 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMLODIPINE-BENAZEPRIL 5-20 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 5-20 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMLODIPINE-BENAZEPRIL 5-40 MG CAPSULE [Lotrel] ![Compare how all Medicare Part D PDP plans in PR cover AMLODIPINE-BENAZEPRIL 5-40 MG CAPSULE [Lotrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
AMMONIUM LACTATE 12% CREAM (g) [Lac-Hydrin] ![Compare how all Medicare Part D PDP plans in PR cover AMMONIUM LACTATE 12% CREAM (g) [Lac-Hydrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMMONIUM LACTATE 12% LOTION ![Compare how all Medicare Part D PDP plans in PR cover AMMONIUM LACTATE 12% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOX-CLAV 200-28.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 200-28.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOX-CLAV 250-62.5 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 250-62.5 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOX-CLAV 400-57 MG/5 ML ORAL SUSPENSION [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 400-57 MG/5 ML ORAL SUSPENSION [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOX-CLAV 500-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 500-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOX-CLAV 600-42.9 MG/5 ML SUS ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 600-42.9 MG/5 ML SUS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOX-CLAV 875-125 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV 875-125 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin] ![Compare how all Medicare Part D PDP plans in PR cover AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOXAPINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOXAPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOXAPINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOXAPINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXAPINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMOXICILLIN 125 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 125 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 125MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 125MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION [Amoxil] ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION [Amoxil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 250 MG CAPSULE [Trimox] ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 250 MG CAPSULE [Trimox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMOXICILLIN 250 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 250 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION [Trimox] ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION [Trimox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION [Amoxil] ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION [Amoxil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 500 MG CAPSULE [Trimox] ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 500 MG CAPSULE [Trimox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMOXICILLIN 875 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMOXICILLIN 875 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMPHETAMINE SALT COMBO 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALT COMBO 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALT COMBO 15MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALT COMBO 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALT COMBO 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALT COMBO 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AMPHETAMINE SALTS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AMPHETAMINE SALTS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
amphotericin b 50mg/10mL 10 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PR cover amphotericin b 50mg/10mL 10 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
AMPICILLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AMPICILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in PR cover Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
AMPICILLIN CAPSULES 500MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN CAPSULES 500MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AMPICILLIN-SULBACTAM 15 GM VIAL [Unasyn] ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN-SULBACTAM 15 GM VIAL [Unasyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
AMPICILLIN-SULBACTAM 3 GM VIAL [Unasyn] ![Compare how all Medicare Part D PDP plans in PR cover AMPICILLIN-SULBACTAM 3 GM VIAL [Unasyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PR cover Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ANASTROZOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ANASTROZOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ANORO ELLIPTA 62.5-25 MCG INH ![Compare how all Medicare Part D PDP plans in PR cover ANORO ELLIPTA 62.5-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
APOKYN 30 MG/3 ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in PR cover APOKYN 30 MG/3 ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
APREPITANT 125 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 125 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:2 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
APREPITANT 125-80-80 MG PACK [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 125-80-80 MG PACK [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:6 /28Days |
APREPITANT 40 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 40 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:1 /30Days |
APREPITANT 80 MG CAPSULE [Emend] ![Compare how all Medicare Part D PDP plans in PR cover APREPITANT 80 MG CAPSULE [Emend].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P Q:4 /28Days |
APTIOM 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
APTIOM 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
APTIOM 600 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
APTIOM 800 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover APTIOM 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
APTIVUS 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PR cover APTIVUS 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ARANESP 10 MCG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 10 MCG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
ARANESP 100ug/0.5mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 100ug/0.5mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP 200MCG/0.4ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 200MCG/0.4ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP 200MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 200MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP 25ug/0.42mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.42 mL in 1 SYRING ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 25ug/0.42mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.42 mL in 1 SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
ARANESP 25ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 25ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
ARANESP 300MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 300MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP 500MCG/1ML SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 500MCG/1ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP 60MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 60MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP 60ug/0.3mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.3 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in PR cover ARANESP 60ug/0.3mL 1 BLISTER PACK in 1 PACKAGE / 4 SYRINGE per BLISTER PACK / 0.3 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR ![Compare how all Medicare Part D PDP plans in PR cover ARANESP PREFILLED SYRINGE SINGLE USE 150MCG 4 SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR ![Compare how all Medicare Part D PDP plans in PR cover ARANESP PREFILLED SYRINGE SINGLE USE 300MCG/0.6ML 300MCG /0.6ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR ![Compare how all Medicare Part D PDP plans in PR cover ARANESP PREFILLED SYRINGE SINGLE USE 40MCG 4 X 40MCG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD ![Compare how all Medicare Part D PDP plans in PR cover ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
ARCALYST 220 MG VIAL ![Compare how all Medicare Part D PDP plans in PR cover ARCALYST 220 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
ARIPIPRAZOLE 10 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 10 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ARIPIPRAZOLE 15 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 15 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ARIPIPRAZOLE 2 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 2 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ARIPIPRAZOLE 20 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 20 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ARIPIPRAZOLE 30 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 30 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ARIPIPRAZOLE 5 MG TABLET [Abilify] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE 5 MG TABLET [Abilify].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt] ![Compare how all Medicare Part D PDP plans in PR cover ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Aspirin-Diphenhydramine ER 25-200 MG ![Compare how all Medicare Part D PDP plans in PR cover Aspirin-Diphenhydramine ER 25-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATAZANAVIR SULFATE 150 MG CAPSULE [Reyataz] ![Compare how all Medicare Part D PDP plans in PR cover ATAZANAVIR SULFATE 150 MG CAPSULE [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATAZANAVIR SULFATE 200 MG CAPSULE [Reyataz] ![Compare how all Medicare Part D PDP plans in PR cover ATAZANAVIR SULFATE 200 MG CAPSULE [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATAZANAVIR SULFATE 300 MG CAPSULE [Reyataz] ![Compare how all Medicare Part D PDP plans in PR cover ATAZANAVIR SULFATE 300 MG CAPSULE [Reyataz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATENOLOL 100 MG TABLET [Tenormin] ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL 100 MG TABLET [Tenormin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ATENOLOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ATENOLOL 50 MG TABLET [Tenormin] ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL 50 MG TABLET [Tenormin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
ATENOLOL-CHLORTHALIDONE 100-25 ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL-CHLORTHALIDONE 100-25.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT) ![Compare how all Medicare Part D PDP plans in PR cover ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATOMOXETINE HCL 10 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 10 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:120 /30Days |
ATOMOXETINE HCL 100 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 100 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATOMOXETINE HCL 18 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 18 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:120 /30Days |
ATOMOXETINE HCL 25 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 25 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:120 /30Days |
ATOMOXETINE HCL 40 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 40 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:60 /30Days |
ATOMOXETINE HCL 60 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 60 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:30 /30Days |
ATOMOXETINE HCL 80 MG CAPSULE [Strattera] ![Compare how all Medicare Part D PDP plans in PR cover ATOMOXETINE HCL 80 MG CAPSULE [Strattera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | S Q:30 /30Days |
ATORVASTATIN 10 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 10 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
ATORVASTATIN 20 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 20 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
ATORVASTATIN 40 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 40 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
ATORVASTATIN 80 MG TABLET [Lipitor] ![Compare how all Medicare Part D PDP plans in PR cover ATORVASTATIN 80 MG TABLET [Lipitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Select Care Drugs |
$2.00 | $4.00 | None |
ATOVAQUONE 750 MG/5 ML SUSP [Mepron] ![Compare how all Medicare Part D PDP plans in PR cover ATOVAQUONE 750 MG/5 ML SUSP [Mepron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone] ![Compare how all Medicare Part D PDP plans in PR cover Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ATOVAQUONE-PROGUANIL 62.5-25 [Malarone] ![Compare how all Medicare Part D PDP plans in PR cover ATOVAQUONE-PROGUANIL 62.5-25 [Malarone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
ATROPINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover ATROPINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:15 /15Days |
ATROVENT HFA AER 17MCG ![Compare how all Medicare Part D PDP plans in PR cover ATROVENT HFA AER 17MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:26 /30Days |
AVONEX PEN 30 MCG/0.5 ML KIT ![Compare how all Medicare Part D PDP plans in PR cover AVONEX PEN 30 MCG/0.5 ML KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
AVONEX PREFILLED SYR 30 MCG KT ![Compare how all Medicare Part D PDP plans in PR cover AVONEX PREFILLED SYR 30 MCG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
AYVAKIT 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AYVAKIT 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
AYVAKIT 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AYVAKIT 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
AYVAKIT 300 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AYVAKIT 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
AZASAN 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZASAN 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
AZASAN 75 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZASAN 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | P |
AZASITE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover AZASITE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZATHIOPRINE 50 MG TABLET [Imuran] ![Compare how all Medicare Part D PDP plans in PR cover AZATHIOPRINE 50 MG TABLET [Imuran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
AZELASTINE 137 MCG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in PR cover AZELASTINE 137 MCG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:30 /25Days |
AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION [Zithromax] ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION [Zithromax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [Zithromax] ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [Zithromax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AZITHROMYCIN 250 MG TABLET [Zithromax Z-Pak] ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 250 MG TABLET [Zithromax Z-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AZITHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak] ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | $28.00 | None |
AZITHROMYCIN 600 MG TABLET [Zithromax Z-Pak] ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN 600 MG TABLET [Zithromax Z-Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
AZITHROMYCIN I.V. 500 MG VIAL [Zithromax] ![Compare how all Medicare Part D PDP plans in PR cover AZITHROMYCIN I.V. 500 MG VIAL [Zithromax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
AZOPT 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PR cover AZOPT 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
AZTREONAM FOR INJECTION ![Compare how all Medicare Part D PDP plans in PR cover AZTREONAM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |