2022 Medicare Part D Plan Formulary Information |
Community Blue Medicare HMO Signature (HMO) (H3957-047-1)
Benefit Details
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The Community Blue Medicare HMO Signature (HMO) (H3957-047-1) Formulary Drugs Starting with the Letter F in Greene County, PA: CMS MA Region 6 which includes: PA
|
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FAMCICLOVIR 125 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FAMCICLOVIR 250 MG TABLET [Famvir] ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 250 MG TABLET [Famvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FAMCICLOVIR 500 MG TABLET [Famvir] ![Compare how all Medicare Part D PDP plans in PA cover FAMCICLOVIR 500 MG TABLET [Famvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FAMOTIDINE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FAMOTIDINE 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FANAPT 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
FANAPT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
FANAPT 12 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
FANAPT 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
FANAPT 6 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
FANAPT 8 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FANAPT 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:62 /31Days |
FANAPT TITR TABLETS ![Compare how all Medicare Part D PDP plans in PA cover FANAPT TITR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:16 /365Days |
FASENRA 30 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover FASENRA 30 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:1 /56Days |
FASENRA PEN 30 MG/ML AUTO INJCT ![Compare how all Medicare Part D PDP plans in PA cover FASENRA PEN 30 MG/ML AUTO INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:1 /56Days |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FELBAMATE 600 MG TABLET [Felbatol] ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 600 MG TABLET [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol] ![Compare how all Medicare Part D PDP plans in PA cover FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FELODIPINE ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil] ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELODIPINE ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FELODIPINE ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FEMYNOR 28 TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in PA cover FEMYNOR 28 TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 134 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 134 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 145 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 145 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 160 MG TABLET [Triglide] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 160 MG TABLET [Triglide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 200 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 200 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 48 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 48 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 54 MG 90 TABLET BOTTLE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 54 MG 90 TABLET BOTTLE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENOFIBRATE 67 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in PA cover FENOFIBRATE 67 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FENTANYL 100 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 100 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:10 /30Days |
FENTANYL 12 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 12 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:20 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL 25 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 25 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | P Q:20 /30Days |
FENTANYL 50 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 50 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | P Q:17 /30Days |
FENTANYL 75 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL 75 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:12 /30Days |
FENTANYL CIT 100 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT 100 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:124 /31Days |
FENTANYL CIT 200 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT 200 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:124 /31Days |
FENTANYL CIT 400 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT 400 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:119 /31Days |
FENTANYL CIT 600 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT 600 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:79 /31Days |
FENTANYL CIT 800 MCG BUCCAL TABLET EFF [Fentora] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT 800 MCG BUCCAL TABLET EFF [Fentora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:59 /31Days |
FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:40 /31Days |
FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /31Days |
FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:124 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:119 /31Days |
FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:79 /31Days |
FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in PA cover FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:59 /31Days |
FENTORA TABLET 100MCG ![Compare how all Medicare Part D PDP plans in PA cover FENTORA TABLET 100MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:124 /31Days |
FENTORA TABLET 200MCG ![Compare how all Medicare Part D PDP plans in PA cover FENTORA TABLET 200MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:124 /31Days |
FENTORA TABLET 400MCG ![Compare how all Medicare Part D PDP plans in PA cover FENTORA TABLET 400MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:119 /31Days |
FENTORA TABLET 600MCG ![Compare how all Medicare Part D PDP plans in PA cover FENTORA TABLET 600MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:79 /31Days |
FENTORA TABLET 800MCG ![Compare how all Medicare Part D PDP plans in PA cover FENTORA TABLET 800MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:59 /31Days |
FERRIPROX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FERRIPROX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FETZIMA 20-40 MG TITRATION PAK ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA 20-40 MG TITRATION PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:56 /365Days |
FETZIMA ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:31 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FETZIMA ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:93 /31Days |
FETZIMA ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:31 /31Days |
FETZIMA ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FETZIMA ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:31 /31Days |
FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN ![Compare how all Medicare Part D PDP plans in PA cover FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FIASP 100 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover FIASP 100 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FIASP PENFILL 100 UNIT/ML CART CARTRIDGE ![Compare how all Medicare Part D PDP plans in PA cover FIASP PENFILL 100 UNIT/ML CART CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FINASTERIDE 5 MG TABLET [Proscar] ![Compare how all Medicare Part D PDP plans in PA cover FINASTERIDE 5 MG TABLET [Proscar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FINTEPLA 2.2 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FINTEPLA 2.2 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:360 /30Days |
FIRDAPSE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FIRDAPSE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:248 /31Days |
FIRVANQ 25 MG/ML SOLUTION SOLUTION RECON ![Compare how all Medicare Part D PDP plans in PA cover FIRVANQ 25 MG/ML SOLUTION SOLUTION RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FIRVANQ 50 MG/ML SOLUTION RECON ![Compare how all Medicare Part D PDP plans in PA cover FIRVANQ 50 MG/ML SOLUTION RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLEBOGAMMA DIF 10% VIAL ![Compare how all Medicare Part D PDP plans in PA cover FLEBOGAMMA DIF 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
FLECAINIDE ACETATE 100 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 100 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLECAINIDE ACETATE 150 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 150 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLECAINIDE ACETATE 50 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in PA cover FLECAINIDE ACETATE 50 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLECTOR 1.3% PATCH TD12 ![Compare how all Medicare Part D PDP plans in PA cover FLECTOR 1.3% PATCH TD12.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | P Q:62 /31Days |
FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 100 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 100 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 150 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 150 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 200 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 200 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE 50 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE 50 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in PA cover FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUCYTOSINE 250 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in PA cover FLUCYTOSINE 250 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FLUCYTOSINE 500 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in PA cover FLUCYTOSINE 500 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FLUDROCORTISONE 0.1 MG TABLET [Florinef] ![Compare how all Medicare Part D PDP plans in PA cover FLUDROCORTISONE 0.1 MG TABLET [Florinef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in PA cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:50 /25Days |
FLUOCINOLONE 0.01% CREAM (G) ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% CREAM (G).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:60 /28Days |
FLUOCINOLONE 0.01% SCALP OIL [Derma-Smoothe/FS] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% SCALP OIL [Derma-Smoothe/FS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:118 /28Days |
FLUOCINOLONE 0.01% SOLUTION [Synalar] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.01% SOLUTION [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:90 /28Days |
FLUOCINOLONE 0.025% CREAM (G) [Synalar] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.025% CREAM (G) [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:120 /28Days |
FLUOCINOLONE 0.025% OINTMENT [Synalar] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE 0.025% OINTMENT [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:120 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINOLONE OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINOLONE OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FLUOCINONIDE 0.05% CREAM (G) [Lidex] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE 0.05% CREAM (G) [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | Q:60 /28Days |
FLUOCINONIDE 0.05% GEL [Lidex] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE 0.05% GEL [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | Q:60 /28Days |
FLUOCINONIDE 0.05% OINTMENT [Lidex] ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE 0.05% OINTMENT [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | Q:60 /28Days |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | Q:60 /28Days |
FLUOCINONIDE-E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in PA cover FLUOCINONIDE-E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | Q:60 /28Days |
Fluorometholone 0.1% drops ![Compare how all Medicare Part D PDP plans in PA cover Fluorometholone 0.1% drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FLUOROURACIL 0.5% CREAM (G) [Carac] ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 0.5% CREAM (G) [Carac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FLUOROURACIL 2% TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 2% TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUOROURACIL 5% CREAM (g) [Efudex] ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 5% CREAM (g) [Efudex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FLUOROURACIL 5% TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FLUOROURACIL 5% TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOXETINE 20 MG/5 ML SOLUTION [Prozac] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE 20 MG/5 ML SOLUTION [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FLUOXETINE HCL 10 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 10 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FLUOXETINE HCL 10 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 10 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUOXETINE HCL 10 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 10 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUOXETINE HCL 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FLUOXETINE HCL 20 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 20 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUOXETINE HCL 20 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 20 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUOXETINE HCL 40 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in PA cover FLUOXETINE HCL 40 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FLUPHENAZINE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 10 MG TABLET [Prolixin] ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 10 MG TABLET [Prolixin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FLUPHENAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate] ![Compare how all Medicare Part D PDP plans in PA cover FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | None |
FLURANDRENOLIDE 0.05% CREAM (G) [Nolix] ![Compare how all Medicare Part D PDP plans in PA cover FLURANDRENOLIDE 0.05% CREAM (G) [Nolix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:120 /28Days |
FLURANDRENOLIDE 0.05% LOTION [Nolix] ![Compare how all Medicare Part D PDP plans in PA cover FLURANDRENOLIDE 0.05% LOTION [Nolix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | Q:120 /28Days |
FLURBIPROFEN 0.03% EYE DROPS [Ocufen] ![Compare how all Medicare Part D PDP plans in PA cover FLURBIPROFEN 0.03% EYE DROPS [Ocufen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA cover Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:16 /30Days |
FLUTICASONE-SALMETEROL 100-50 INHALER [Advair] ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE-SALMETEROL 100-50 INHALER [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:1 /30Days |
FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:1 /30Days |
FLUTICASONE-SALMETEROL 250-50 INHALER [Advair] ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE-SALMETEROL 250-50 INHALER [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:60 /30Days |
FLUTICASONE-SALMETEROL 500-50 INHALER [Advair] ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE-SALMETEROL 500-50 INHALER [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:60 /30Days |
FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in PA cover FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $120.00 | Q:1 /30Days |
FLUVOXAMINE ER 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE ER 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FLUVOXAMINE ER 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE ER 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FLUVOXAMINE MALEATE 100 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE MALEATE 100 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUVOXAMINE MALEATE 25 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE MALEATE 25 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FLUVOXAMINE MALEATE 50 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in PA cover FLUVOXAMINE MALEATE 50 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FONDAPARINUX 2.5 MG/0.5 ML SYR SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover FONDAPARINUX 2.5 MG/0.5 ML SYR SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in PA cover FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:2 /28Days |
FOSAMPRENAVIR 700 MG TABLET [Lexiva] ![Compare how all Medicare Part D PDP plans in PA cover FOSAMPRENAVIR 700 MG TABLET [Lexiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FOSINOPRIL SODIUM 10 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 10 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FOSINOPRIL SODIUM 20 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 20 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FOSINOPRIL SODIUM 40 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL SODIUM 40 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in PA cover FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FOTIVDA 0.89 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FOTIVDA 0.89 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:21 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOTIVDA 1.34 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover FOTIVDA 1.34 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:21 /28Days |
FULPHILA 6 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover FULPHILA 6 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FUROSEMIDE 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FUROSEMIDE 100 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 100 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P ![Compare how all Medicare Part D PDP plans in PA cover Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FUROSEMIDE 20 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 20 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FUROSEMIDE 40 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 40 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $0.00 | None |
FUROSEMIDE 80 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in PA cover FUROSEMIDE 80 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
FUZEON 90 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover FUZEON 90 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FYCOMPA 0.5 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 0.5 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FYCOMPA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FYCOMPA 12 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FYCOMPA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $275.00 | None |
FYCOMPA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FYCOMPA 6 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
FYCOMPA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover FYCOMPA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |