2021 Medicare Part D Plan Formulary Information |
Elixir RxSecure (PDP) (S7694-030-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Elixir RxSecure (PDP). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Elixir RxSecure (PDP) (S7694-030-0) Formulary Drugs Starting with the Letter D in CMS PDP Region 30 which includes: OR WA Plan Monthly Premium: $32.50 Deductible: $445 Qualifies for LIS: Yes |
Drugs Starting with Letter D
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
D-AMPHETAMINE ER 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover D-AMPHETAMINE ER 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:120 /30Days |
D-AMPHETAMINE ER 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover D-AMPHETAMINE ER 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:360 /30Days |
D5%-1/2NS-KCL 10 MEQ/L IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover D5%-1/2NS-KCL 10 MEQ/L IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
D5%-1/2NS-KCL 30 MEQ/L IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover D5%-1/2NS-KCL 30 MEQ/L IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
D5%-1/2NS-KCL 40 MEQ/L IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover D5%-1/2NS-KCL 40 MEQ/L IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DALFAMPRIDINE ER 10 MG TABLET ER 12H [Ampyra] ![Compare how all Medicare Part D PDP plans in OR cover DALFAMPRIDINE ER 10 MG TABLET ER 12H [Ampyra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
DALIRESP 250 MCG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DALIRESP 250 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | Q:30 /30Days |
DALIRESP 500 MCG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DALIRESP 500 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | Q:30 /30Days |
DANAZOL 100 MG CAPSULE [Danocrine] ![Compare how all Medicare Part D PDP plans in OR cover DANAZOL 100 MG CAPSULE [Danocrine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DANAZOL 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DANAZOL 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DANAZOL CAPSULES USP 200MG (100 CT) ![Compare how all Medicare Part D PDP plans in OR cover DANAZOL CAPSULES USP 200MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DAPSONE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DAPSONE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DAPSONE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DAPSONE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DAPTACEL DTAP VACCINE VIAL ![Compare how all Medicare Part D PDP plans in OR cover DAPTACEL DTAP VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DAPTOMYCIN 350 MG VIAL [Cubicin RF] ![Compare how all Medicare Part D PDP plans in OR cover DAPTOMYCIN 350 MG VIAL [Cubicin RF].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DAPTOMYCIN 500 MG VIAL [Cubicin RF] ![Compare how all Medicare Part D PDP plans in OR cover DAPTOMYCIN 500 MG VIAL [Cubicin RF].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
DARIFENACIN ER 15 MG TABLET 24H [Enablex] ![Compare how all Medicare Part D PDP plans in OR cover DARIFENACIN ER 15 MG TABLET 24H [Enablex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DARIFENACIN ER 7.5 MG TABLET 24H [Enablex] ![Compare how all Medicare Part D PDP plans in OR cover DARIFENACIN ER 7.5 MG TABLET 24H [Enablex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DAURISMO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DAURISMO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DAURISMO 25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DAURISMO 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEBLITANE 0.35 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEBLITANE 0.35 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DEFERASIROX 125 MG TABLET DISPER [Exjade] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 125 MG TABLET DISPER [Exjade].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 180 MG GRANULE GRAN PACK [Jadenu] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 180 MG GRANULE GRAN PACK [Jadenu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 180 MG TABLET [Jadenu] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 180 MG TABLET [Jadenu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 250 MG TABLET DISPER [Exjade] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 250 MG TABLET DISPER [Exjade].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 360 MG GRANULE GRAN PACK [Jadenu] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 360 MG GRANULE GRAN PACK [Jadenu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 360 MG TABLET [Jadenu] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 360 MG TABLET [Jadenu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 500 MG TABLET DISPER [Exjade] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 500 MG TABLET DISPER [Exjade].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 90 MG GRANULE GRAN PACK [Jadenu] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 90 MG GRANULE GRAN PACK [Jadenu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERASIROX 90 MG TABLET [Jadenu] ![Compare how all Medicare Part D PDP plans in OR cover DEFERASIROX 90 MG TABLET [Jadenu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DEFERIPRONE 500 MG TABLET [Ferriprox] ![Compare how all Medicare Part D PDP plans in OR cover DEFERIPRONE 500 MG TABLET [Ferriprox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DELSTRIGO 100-300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DELSTRIGO 100-300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DESCOVY 200-25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DESCOVY 200-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
DESIPRAMINE 10 MG TABLET [Norpramin] ![Compare how all Medicare Part D PDP plans in OR cover DESIPRAMINE 10 MG TABLET [Norpramin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESIPRAMINE 100 MG TABLET [Norpramin] ![Compare how all Medicare Part D PDP plans in OR cover DESIPRAMINE 100 MG TABLET [Norpramin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESIPRAMINE 150 MG TABLET [Norpramin] ![Compare how all Medicare Part D PDP plans in OR cover DESIPRAMINE 150 MG TABLET [Norpramin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESIPRAMINE 25 MG TABLET [Norpramin] ![Compare how all Medicare Part D PDP plans in OR cover DESIPRAMINE 25 MG TABLET [Norpramin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESIPRAMINE 50 MG TABLET [Norpramin] ![Compare how all Medicare Part D PDP plans in OR cover DESIPRAMINE 50 MG TABLET [Norpramin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESIPRAMINE 75 MG TABLET [Norpramin] ![Compare how all Medicare Part D PDP plans in OR cover DESIPRAMINE 75 MG TABLET [Norpramin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESLORATADINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DESLORATADINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DESMOPRESSIN ACETATE 0.1 MG TABLET [DDAVP] ![Compare how all Medicare Part D PDP plans in OR cover DESMOPRESSIN ACETATE 0.1 MG TABLET [DDAVP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DESMOPRESSIN ACETATE 0.2 MG TABLET [DDAVP] ![Compare how all Medicare Part D PDP plans in OR cover DESMOPRESSIN ACETATE 0.2 MG TABLET [DDAVP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DESMOPRESSIN ACETATE NASAL SOLUTION 0.1% 5 ML BOTSPR ![Compare how all Medicare Part D PDP plans in OR cover DESMOPRESSIN ACETATE NASAL SOLUTION 0.1% 5 ML BOTSPR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DESOGESTR-ETH ESTRAD ETH ESTRA TABLET [Volnea] ![Compare how all Medicare Part D PDP plans in OR cover DESOGESTR-ETH ESTRAD ETH ESTRA TABLET [Volnea].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESONIDE 0.05% CREAM (g) [Tridesilon] ![Compare how all Medicare Part D PDP plans in OR cover DESONIDE 0.05% CREAM (g) [Tridesilon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESONIDE 0.05% LOTION [LoKara] ![Compare how all Medicare Part D PDP plans in OR cover DESONIDE 0.05% LOTION [LoKara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESONIDE 0.05% OINTMENT [Tridesilon] ![Compare how all Medicare Part D PDP plans in OR cover DESONIDE 0.05% OINTMENT [Tridesilon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Desoximetasone 0.0005 MG/MG Topical Ointment ![Compare how all Medicare Part D PDP plans in OR cover Desoximetasone 0.0005 MG/MG Topical Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESOXIMETASONE 0.05% CREAM (G) [Topicort LP] ![Compare how all Medicare Part D PDP plans in OR cover DESOXIMETASONE 0.05% CREAM (G) [Topicort LP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESOXIMETASONE 0.25% CREAM ![Compare how all Medicare Part D PDP plans in OR cover DESOXIMETASONE 0.25% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESOXIMETASONE 0.25% OINTMENT [Topicort] ![Compare how all Medicare Part D PDP plans in OR cover DESOXIMETASONE 0.25% OINTMENT [Topicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Desoximetasone 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in OR cover Desoximetasone 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DESVENLAFAXINE ER 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DESVENLAFAXINE ER 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:120 /30Days |
DESVENLAFAXINE ER 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DESVENLAFAXINE ER 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DESVENLAFAXINE SUC ER 100 MG TABLET ER 24H [Pristiq] ![Compare how all Medicare Part D PDP plans in OR cover DESVENLAFAXINE SUC ER 100 MG TABLET ER 24H [Pristiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:120 /30Days |
DESVENLAFAXINE SUC ER 25 MG TABLET ER 24H [Pristiq] ![Compare how all Medicare Part D PDP plans in OR cover DESVENLAFAXINE SUC ER 25 MG TABLET ER 24H [Pristiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
DESVENLAFAXINE SUCCNT ER 50 MG TABLET ER 24H [Pristiq] ![Compare how all Medicare Part D PDP plans in OR cover DESVENLAFAXINE SUCCNT ER 50 MG TABLET ER 24H [Pristiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
DEXAMETHASONE 0.1% EYE DROP ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 0.1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DEXAMETHASONE 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DEXAMETHASONE 0.5MG/5ML ELX ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 0.5MG/5ML ELX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DEXAMETHASONE 0.75MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 0.75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DEXAMETHASONE 1.5MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DEXAMETHASONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DEXAMETHASONE 2MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DEXAMETHASONE 4MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DEXAMETHASONE 6MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXAMETHASONE 6MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DEXILANT CAPSULES DELAYED RELEASE 30 MG ![Compare how all Medicare Part D PDP plans in OR cover DEXILANT CAPSULES DELAYED RELEASE 30 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DEXILANT DR 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DEXILANT DR 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DEXMETHYLPHENIDATE 10 MG TABLET [Focalin] ![Compare how all Medicare Part D PDP plans in OR cover DEXMETHYLPHENIDATE 10 MG TABLET [Focalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | Q:60 /30Days |
DEXMETHYLPHENIDATE 2.5 MG TABLET [Focalin] ![Compare how all Medicare Part D PDP plans in OR cover DEXMETHYLPHENIDATE 2.5 MG TABLET [Focalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | Q:90 /30Days |
DEXMETHYLPHENIDATE 5 MG TABLET [Focalin] ![Compare how all Medicare Part D PDP plans in OR cover DEXMETHYLPHENIDATE 5 MG TABLET [Focalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | Q:120 /30Days |
DEXTROAMP-AMPHETAMIN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXTROAMP-AMPHETAMIN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | Q:90 /30Days |
DEXTROAMP-AMPHETAMIN 30 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DEXTROAMP-AMPHETAMIN 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | Q:60 /30Days |
DEXTROAMPHETAMINE 10 MG TABLET [Zenzedi] ![Compare how all Medicare Part D PDP plans in OR cover DEXTROAMPHETAMINE 10 MG TABLET [Zenzedi].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:180 /30Days |
DEXTROAMPHETAMINE 5 MG TABLET [Zenzedi] ![Compare how all Medicare Part D PDP plans in OR cover DEXTROAMPHETAMINE 5 MG TABLET [Zenzedi].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:150 /30Days |
DEXTROAMPHETAMINE ER 10 MG CAPSULE ER [Dexedrine Spansule] ![Compare how all Medicare Part D PDP plans in OR cover DEXTROAMPHETAMINE ER 10 MG CAPSULE ER [Dexedrine Spansule].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DEXTROAMPHETAMINE SACCHARATE AND SULFATE AMPHETAMINE ASPARTATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in OR cover DEXTROAMPHETAMINE SACCHARATE AND SULFATE AMPHETAMINE ASPARTATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | Q:90 /30Days |
DEXTROSE 10%-1/4NS IV TUBEX ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 10%-1/4NS IV TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE 10%-WATER IV SOLUTION DEHP FR BG ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 10%-WATER IV SOLUTION DEHP FR BG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE 2.5%-1/2NS IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 2.5%-1/2NS IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE 5%-0.2% NACL IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 5%-0.2% NACL IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE 5%-0.45% NACL IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 5%-0.45% NACL IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE 5%-0.9% NACL IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 5%-0.9% NACL IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE 5%-WATER IV SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE 5%-WATER IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DEXTROSE IN SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in OR cover DEXTROSE IN SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
DIACOMIT 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DIACOMIT 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DIACOMIT 250 MG POWDER PACK ![Compare how all Medicare Part D PDP plans in OR cover DIACOMIT 250 MG POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DIACOMIT 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DIACOMIT 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DIACOMIT 500 MG POWDER PACK ![Compare how all Medicare Part D PDP plans in OR cover DIACOMIT 500 MG POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DIAZEPAM 10 MG RECTAL GEL SYST KIT [Diastat] ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 10 MG RECTAL GEL SYST KIT [Diastat].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIAZEPAM 10 MG TABLET [Valium] ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 10 MG TABLET [Valium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | Q:120 /30Days |
DIAZEPAM 2 MG TABLET [Valium] ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 2 MG TABLET [Valium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | Q:600 /30Days |
DIAZEPAM 2.5 MG RECTAL GEL SYST KIT [Diastat] ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 2.5 MG RECTAL GEL SYST KIT [Diastat].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIAZEPAM 20 MG RECTAL GEL SYST KIT [Diastat] ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 20 MG RECTAL GEL SYST KIT [Diastat].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIAZEPAM 5 MG TABLET [Valium] ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 5 MG TABLET [Valium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | Q:240 /30Days |
DIAZEPAM 5 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 5 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:1200 /30Days |
DIAZEPAM 5 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in OR cover DIAZEPAM 5 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:240 /30Days |
DIAZOXIDE 50 MG/ML ORAL SUSPENSION [Proglycem] ![Compare how all Medicare Part D PDP plans in OR cover DIAZOXIDE 50 MG/ML ORAL SUSPENSION [Proglycem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DICLOFENAC 0.1% EYE DROPS [Voltaren] ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC 0.1% EYE DROPS [Voltaren].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DICLOFENAC POT 50 MG TABLET [Cataflam] ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC POT 50 MG TABLET [Cataflam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICLOFENAC SOD EC 25 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC SOD EC 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICLOFENAC SOD EC 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC SOD EC 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DICLOFENAC SOD EC 75 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC SOD EC 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DICLOFENAC SOD ER 100 MG TABLET ER 24H [Voltaren-XR] ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC SOD ER 100 MG TABLET ER 24H [Voltaren-XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICLOFENAC SODIUM 1.5% SOLUTION ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC SODIUM 1.5% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICLOFENAC SODIUM 1% GEL [Voltaren Gel] ![Compare how all Medicare Part D PDP plans in OR cover DICLOFENAC SODIUM 1% GEL [Voltaren Gel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICLOXACILLIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DICLOXACILLIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICLOXACILLIN SODIUM 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DICLOXACILLIN SODIUM 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DICYCLOMINE 10 MG CAPSULE [Bentyl] ![Compare how all Medicare Part D PDP plans in OR cover DICYCLOMINE 10 MG CAPSULE [Bentyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DICYCLOMINE 20 MG TABLET [Bentyl] ![Compare how all Medicare Part D PDP plans in OR cover DICYCLOMINE 20 MG TABLET [Bentyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $0.00 | None |
DICYCLOMINE HCL 10MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in OR cover DICYCLOMINE HCL 10MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIFLUNISAL 500 MG TABLET [Dolobid] ![Compare how all Medicare Part D PDP plans in OR cover DIFLUNISAL 500 MG TABLET [Dolobid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIGITEK 125 MCG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIGITEK 125 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DIGITEK 250 MCG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIGITEK 250 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIGOX 125 MCG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIGOX 125 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DIGOX 250 MCG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIGOX 250 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIGOXIN 0.05 MG/ML SOLUTION [Lanoxin] ![Compare how all Medicare Part D PDP plans in OR cover DIGOXIN 0.05 MG/ML SOLUTION [Lanoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIGOXIN 125 MCG TABLET [Lanoxin] ![Compare how all Medicare Part D PDP plans in OR cover DIGOXIN 125 MCG TABLET [Lanoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DIGOXIN 250 MCG TABLET [Lanoxin] ![Compare how all Medicare Part D PDP plans in OR cover DIGOXIN 250 MCG TABLET [Lanoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIHYDROERGOTAMINE 4 MG/ML SPRAY ![Compare how all Medicare Part D PDP plans in OR cover DIHYDROERGOTAMINE 4 MG/ML SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:8 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DILANTIN CAPSULES 30 MG ER ![Compare how all Medicare Part D PDP plans in OR cover DILANTIN CAPSULES 30 MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DILT XR 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DILT XR 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILT XR 180 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DILT XR 180 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILT XR 240 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DILT XR 240 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILTIAZEM 120 MG TABLET [Cardizem] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 120 MG TABLET [Cardizem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DILTIAZEM 12HR ER 120 MG CAPSULE [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 12HR ER 120 MG CAPSULE [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DILTIAZEM 12HR ER 60 MG CAPSULE [Cardizem SR] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 12HR ER 60 MG CAPSULE [Cardizem SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DILTIAZEM 12HR ER 90 MG CAPSULE [Cardizem SR] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 12HR ER 90 MG CAPSULE [Cardizem SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DILTIAZEM 24HR ER 120 MG CAPSULE [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 24HR ER 120 MG CAPSULE [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILTIAZEM 24HR ER 180 MG CAPSULE [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 24HR ER 180 MG CAPSULE [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILTIAZEM 24HR ER 240 MG CAPSULE [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 24HR ER 240 MG CAPSULE [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DILTIAZEM 24HR ER 300 MG CAPSULE [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 24HR ER 300 MG CAPSULE [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILTIAZEM 24HR ER 360 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 24HR ER 360 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILTIAZEM 24HR ER 420 MG CAPSULE [Tiazac] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 24HR ER 420 MG CAPSULE [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DILTIAZEM 30 MG TABLET [Cardizem] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 30 MG TABLET [Cardizem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DILTIAZEM 60 MG TABLET [Cardizem] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 60 MG TABLET [Cardizem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DILTIAZEM 90 MG TABLET [Cardizem] ![Compare how all Medicare Part D PDP plans in OR cover DILTIAZEM 90 MG TABLET [Cardizem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
Diph-Tetanus Tox-Acell Pert adsorbed and IPV vaccine 0.5 ML Prefilled Syringe [Kinrix] ![Compare how all Medicare Part D PDP plans in OR cover Diph-Tetanus Tox-Acell Pert adsorbed and IPV vaccine 0.5 ML Prefilled Syringe [Kinrix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
Diph-Tetanus Tox-Acell Pert-Hepatitis B-Polio IPV Vac 0.5 ML Prefilled Syringe [Pediarix] ![Compare how all Medicare Part D PDP plans in OR cover Diph-Tetanus Tox-Acell Pert-Hepatitis B-Polio IPV Vac 0.5 ML Prefilled Syringe [Pediarix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIPHENOXYLATE-ATROP 2.5-0.025 TABLET [Vi-Atro] ![Compare how all Medicare Part D PDP plans in OR cover DIPHENOXYLATE-ATROP 2.5-0.025 TABLET [Vi-Atro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIPHENOXYLATE/ATROPINE LIQ ![Compare how all Medicare Part D PDP plans in OR cover DIPHENOXYLATE/ATROPINE LIQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Diphtheria Toxoid Vaccine 25 UNT/ML / Tetanus Toxoid Vaccine 5 UNT per 0.5 ML Injectable Suspension ![Compare how all Medicare Part D PDP plans in OR cover Diphtheria Toxoid Vaccine 25 UNT/ML / Tetanus Toxoid Vaccine 5 UNT per 0.5 ML Injectable Suspension.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DISULFIRAM 250 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DISULFIRAM 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DISULFIRAM 500 MG TABLET [Antabuse] ![Compare how all Medicare Part D PDP plans in OR cover DISULFIRAM 500 MG TABLET [Antabuse].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DIVALPROEX DR 125 MG CAPSULE SPRNK ![Compare how all Medicare Part D PDP plans in OR cover DIVALPROEX DR 125 MG CAPSULE SPRNK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIVALPROEX SOD DR 125 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIVALPROEX SOD DR 125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIVALPROEX SOD DR 250 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIVALPROEX SOD DR 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIVALPROEX SOD DR 500 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DIVALPROEX SOD DR 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DIVALPROEX SOD ER 250 MG TABLET ER 24H [Depakote ER] ![Compare how all Medicare Part D PDP plans in OR cover DIVALPROEX SOD ER 250 MG TABLET ER 24H [Depakote ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DIVALPROEX SOD ER 500 MG TABLET ER 24H [Depakote ER] ![Compare how all Medicare Part D PDP plans in OR cover DIVALPROEX SOD ER 500 MG TABLET ER 24H [Depakote ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOFETILIDE 125 MCG CAPSULE [Tikosyn] ![Compare how all Medicare Part D PDP plans in OR cover DOFETILIDE 125 MCG CAPSULE [Tikosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOFETILIDE 250 MCG CAPSULE [Tikosyn] ![Compare how all Medicare Part D PDP plans in OR cover DOFETILIDE 250 MCG CAPSULE [Tikosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOFETILIDE 500 MCG CAPSULE [Tikosyn] ![Compare how all Medicare Part D PDP plans in OR cover DOFETILIDE 500 MCG CAPSULE [Tikosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DOJOLVI LIQUID ![Compare how all Medicare Part D PDP plans in OR cover DOJOLVI LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DONEPEZIL HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DONEPEZIL HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DONEPEZIL HCL 23 MG TABLET [Aricept] ![Compare how all Medicare Part D PDP plans in OR cover DONEPEZIL HCL 23 MG TABLET [Aricept].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DONEPEZIL HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DONEPEZIL HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DONEPEZIL HCL ODT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DONEPEZIL HCL ODT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DONEPEZIL HCL ODT 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DONEPEZIL HCL ODT 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DORZOLAMIDE HCL 2% EYE DROPS [Trusopt] ![Compare how all Medicare Part D PDP plans in OR cover DORZOLAMIDE HCL 2% EYE DROPS [Trusopt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
Dorzolamide Hydrochloride and Timolol Maleate 20; 5mg/mL; mg/mL 1 BOTTLE, DROPPER in 1 BOX / 10 mL ![Compare how all Medicare Part D PDP plans in OR cover Dorzolamide Hydrochloride and Timolol Maleate 20; 5mg/mL; mg/mL 1 BOTTLE, DROPPER in 1 BOX / 10 mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DORZOLAMIDE-TIMOLOL 2%-0.5% DROPERETTE [Cosopt PF] ![Compare how all Medicare Part D PDP plans in OR cover DORZOLAMIDE-TIMOLOL 2%-0.5% DROPERETTE [Cosopt PF].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOVATO 50-300 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DOVATO 50-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
DOXAZOSIN MESYLATE 1 MG TABLET [Cardura] ![Compare how all Medicare Part D PDP plans in OR cover DOXAZOSIN MESYLATE 1 MG TABLET [Cardura].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DOXAZOSIN MESYLATE 2 MG TABLET [Cardura] ![Compare how all Medicare Part D PDP plans in OR cover DOXAZOSIN MESYLATE 2 MG TABLET [Cardura].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DOXAZOSIN MESYLATE 4 MG TABLET [Cardura] ![Compare how all Medicare Part D PDP plans in OR cover DOXAZOSIN MESYLATE 4 MG TABLET [Cardura].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DOXAZOSIN MESYLATE 8 MG TABLET [Cardura] ![Compare how all Medicare Part D PDP plans in OR cover DOXAZOSIN MESYLATE 8 MG TABLET [Cardura].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DOXEPIN 10 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN 10 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXEPIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXEPIN 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXEPIN 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXEPIN HCL 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN HCL 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXEPIN HCL 3 MG TABLET [Silenor] ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN HCL 3 MG TABLET [Silenor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXEPIN HCL 6 MG TABLET [Silenor] ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN HCL 6 MG TABLET [Silenor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Doxepin Hydrochloride 150mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in OR cover Doxepin Hydrochloride 150mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DOXEPIN HYDROCHLORIDE CAPSULES 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in OR cover DOXEPIN HYDROCHLORIDE CAPSULES 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXY 100 VIAL ![Compare how all Medicare Part D PDP plans in OR cover DOXY 100 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXYCYCLINE HYCLATE 100 MG CAPSULE [Vibramycin] ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE HYCLATE 100 MG CAPSULE [Vibramycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DOXYCYCLINE HYCLATE 100 MG TABLET [Vibra-Tabs] ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE HYCLATE 100 MG TABLET [Vibra-Tabs].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DOXYCYCLINE HYCLATE 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE HYCLATE 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DOXYCYCLINE HYCLATE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE HYCLATE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DOXYCYCLINE MONO 100 MG CAPSULE [Monodox] ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE MONO 100 MG CAPSULE [Monodox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DOXYCYCLINE MONO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE MONO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DOXYCYCLINE MONO 50 MG CAPSULE [Monodox] ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE MONO 50 MG CAPSULE [Monodox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DOXYCYCLINE MONO 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DOXYCYCLINE MONO 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DRIZALMA SPRINKLE DR 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DRIZALMA SPRINKLE DR 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DRIZALMA SPRINKLE DR 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DRIZALMA SPRINKLE DR 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DRIZALMA SPRINKLE DR 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DRIZALMA SPRINKLE DR 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DRIZALMA SPRINKLE DR 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DRIZALMA SPRINKLE DR 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DRONABINOL 10 MG CAPSULE [Marinol] ![Compare how all Medicare Part D PDP plans in OR cover DRONABINOL 10 MG CAPSULE [Marinol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P Q:60 /30Days |
DRONABINOL 2.5 MG CAPSULE [Marinol] ![Compare how all Medicare Part D PDP plans in OR cover DRONABINOL 2.5 MG CAPSULE [Marinol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P Q:60 /30Days |
DRONABINOL 5 MG CAPSULE [Marinol] ![Compare how all Medicare Part D PDP plans in OR cover DRONABINOL 5 MG CAPSULE [Marinol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P Q:60 /30Days |
DROSPIRENONE-EE 3-0.03 MG TABLET [Zumandimine] ![Compare how all Medicare Part D PDP plans in OR cover DROSPIRENONE-EE 3-0.03 MG TABLET [Zumandimine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
DROXIA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DROXIA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DROXIA 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DROXIA 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DROXIA 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in OR cover DROXIA 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DROXIDOPA 100 MG CAPSULE [NORTHERA] ![Compare how all Medicare Part D PDP plans in OR cover DROXIDOPA 100 MG CAPSULE [NORTHERA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DROXIDOPA 200 MG CAPSULE [NORTHERA] ![Compare how all Medicare Part D PDP plans in OR cover DROXIDOPA 200 MG CAPSULE [NORTHERA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:180 /30Days |
DROXIDOPA 300 MG CAPSULE [NORTHERA] ![Compare how all Medicare Part D PDP plans in OR cover DROXIDOPA 300 MG CAPSULE [NORTHERA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:180 /30Days |
DUAVEE 0.45-20 MG TABLET ![Compare how all Medicare Part D PDP plans in OR cover DUAVEE 0.45-20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
DULOXETINE HCL DR 20 MG CAPSULE [Cymbalta] ![Compare how all Medicare Part D PDP plans in OR cover DULOXETINE HCL DR 20 MG CAPSULE [Cymbalta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DULOXETINE HCL DR 30 MG CAPSULE [Cymbalta] ![Compare how all Medicare Part D PDP plans in OR cover DULOXETINE HCL DR 30 MG CAPSULE [Cymbalta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DULOXETINE HCL DR 40 MG CAPSULE [Irenka] ![Compare how all Medicare Part D PDP plans in OR cover DULOXETINE HCL DR 40 MG CAPSULE [Irenka].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DULOXETINE HCL DR 60 MG CAPSULE [Cymbalta] ![Compare how all Medicare Part D PDP plans in OR cover DULOXETINE HCL DR 60 MG CAPSULE [Cymbalta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
DUPIXENT 200 MG/1.14 ML SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover DUPIXENT 200 MG/1.14 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DUPIXENT 300 MG/2 ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in OR cover DUPIXENT 300 MG/2 ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DUPIXENT 300 MG/2 ML SAFE SYRINGE ![Compare how all Medicare Part D PDP plans in OR cover DUPIXENT 300 MG/2 ML SAFE SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
DUREZOL 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in OR cover DUREZOL 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
DUTASTERIDE 0.5 MG CAPSULE [Avodart] ![Compare how all Medicare Part D PDP plans in OR cover DUTASTERIDE 0.5 MG CAPSULE [Avodart].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | $10.50 | None |
DUTASTERIDE-TAMSULOSIN 0.5-0.4 CPMP 24HR [Jalyn] ![Compare how all Medicare Part D PDP plans in OR cover DUTASTERIDE-TAMSULOSIN 0.5-0.4 CPMP 24HR [Jalyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |