2022 Medicare Part D Plan Formulary Information |
HealthPartners Robin Maple (PPO) (H4882-005-0)
Benefit Details
![Email Prescription and/or Health Benefit details for HealthPartners Robin Maple (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) This plan covers select insulin pay $35 copay.
See individual insulin cost-sharing below. |
The HealthPartners Robin Maple (PPO) (H4882-005-0) Formulary Drugs Starting with the Letter R in Waushara County, WI: CMS MA Region 14 which includes: WI
|
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
RABAVERT RABIES VACCINE VIAL ![Compare how all Medicare Part D PDP plans in WI cover RABAVERT RABIES VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
RABEPRAZOLE SOD DR 20 MG TABLET DR [AcipHex] ![Compare how all Medicare Part D PDP plans in WI cover RABEPRAZOLE SOD DR 20 MG TABLET DR [AcipHex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RALOXIFENE HCL 60 MG TABLET [Evista] ![Compare how all Medicare Part D PDP plans in WI cover RALOXIFENE HCL 60 MG TABLET [Evista].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RAMELTEON 8 MG TABLET [Rozerem] ![Compare how all Medicare Part D PDP plans in WI cover RAMELTEON 8 MG TABLET [Rozerem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:1 /1Days |
RAMIPRIL 1.25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 1.25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
RAMIPRIL 10 MG CAPSULE [Altace] ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 10 MG CAPSULE [Altace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
RAMIPRIL 2.5 MG CAPSULE [Altace] ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 2.5 MG CAPSULE [Altace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
RAMIPRIL 5 MG CAPSULE [Altace] ![Compare how all Medicare Part D PDP plans in WI cover RAMIPRIL 5 MG CAPSULE [Altace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
RANOLAZINE ER 1,000 MG TABLET ER 12H [Ranexa] ![Compare how all Medicare Part D PDP plans in WI cover RANOLAZINE ER 1,000 MG TABLET ER 12H [Ranexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RANOLAZINE ER 500 MG TABLET ER 12H [Ranexa] ![Compare how all Medicare Part D PDP plans in WI cover RANOLAZINE ER 500 MG TABLET ER 12H [Ranexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RASAGILINE MESYLATE 0.5 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in WI cover RASAGILINE MESYLATE 0.5 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RASAGILINE MESYLATE 1 MG TABLET [Azilect] ![Compare how all Medicare Part D PDP plans in WI cover RASAGILINE MESYLATE 1 MG TABLET [Azilect].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RASUVO 10 MG/0.2 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 10 MG/0.2 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 12.5 MG/0.25 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 12.5 MG/0.25 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 15 MG/0.3 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 15 MG/0.3 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 17.5 MG/0.35 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 17.5 MG/0.35 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 20 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 20 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 22.5 MG/0.45 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 22.5 MG/0.45 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 25 MG/0.5 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 25 MG/0.5 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 30 MG/0.6 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 30 MG/0.6 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RASUVO 7.5 MG/0.15 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in WI cover RASUVO 7.5 MG/0.15 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RAVICTI 1.1 GRAM/ML LIQUID ![Compare how all Medicare Part D PDP plans in WI cover RAVICTI 1.1 GRAM/ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:6 /28Days |
REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:6 /28Days |
REBIF REBIDOSE 22 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE 22 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:6 /28Days |
REBIF REBIDOSE 44 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE 44 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:6 /28Days |
REBIF REBIDOSE TITRATION PACK ![Compare how all Medicare Part D PDP plans in WI cover REBIF REBIDOSE TITRATION PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:4 /28Days |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in WI cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:4 /28Days |
RECLIPSEN 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WI cover RECLIPSEN 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RECOMBIVAX HB 10 MCG/ML SYR ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 10 MCG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
RECOMBIVAX HB 10 MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 10 MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RECTIV 0.4% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover RECTIV 0.4% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
REDITREX 10 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 10 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 12.5 MG/0.5 ML SYRING SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 12.5 MG/0.5 ML SYRING SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 15 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 15 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 17.5 MG/0.7 ML SYRING SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 17.5 MG/0.7 ML SYRING SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 20 MG/0.8 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 20 MG/0.8 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 22.5 MG/0.9 ML SYRING SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 22.5 MG/0.9 ML SYRING SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 25 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 25 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REDITREX 7.5 MG/0.3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REDITREX 7.5 MG/0.3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in WI cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | None |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in WI cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REPAGLINIDE 0.5 MG TABLET [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover REPAGLINIDE 0.5 MG TABLET [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
REPAGLINIDE 1 MG TABLET [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover REPAGLINIDE 1 MG TABLET [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
REPAGLINIDE 2 MG TABLET [Prandin] ![Compare how all Medicare Part D PDP plans in WI cover REPAGLINIDE 2 MG TABLET [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
REPATHA 140 MG/ML SURECLICK PEN INJCTR ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 140 MG/ML SURECLICK PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
REPATHA 140 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 140 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
REPATHA 420 MG/3.5ML PUSHTRONX WEAR INJCT ![Compare how all Medicare Part D PDP plans in WI cover REPATHA 420 MG/3.5ML PUSHTRONX WEAR INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RESTASIS 0.05% EYE EMULSION ![Compare how all Medicare Part D PDP plans in WI cover RESTASIS 0.05% EYE EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RESTASIS MULTIDOSE 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover RESTASIS MULTIDOSE 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RETACRIT 10,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 10,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RETACRIT 2,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 2,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RETACRIT 20,000 UNIT/2 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 20,000 UNIT/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RETACRIT 20,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 20,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RETACRIT 3,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 3,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RETACRIT 4,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 4,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RETACRIT 40,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover RETACRIT 40,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RETEVMO 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RETEVMO 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RETEVMO 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RETEVMO 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REVCOVI 2.4 MG/1.5 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover REVCOVI 2.4 MG/1.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REVLIMID 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:30 /30Days |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:30 /30Days |
REVLIMID 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:30 /30Days |
REVLIMID 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVLIMID 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:30 /30Days |
REVLIMID 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover REVLIMID 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | Q:30 /30Days |
REXULTI 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REXULTI 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REXULTI 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REXULTI 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REXULTI 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REXULTI 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REXULTI 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
REYATAZ 50 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover REYATAZ 50 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | None |
REYVOW 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REYVOW 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
REYVOW 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REYVOW 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REZUROCK 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover REZUROCK 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RHOPRESSA 0.02% OPHTH SOLUTION Drops ![Compare how all Medicare Part D PDP plans in WI cover RHOPRESSA 0.02% OPHTH SOLUTION Drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RIBAVIRIN 200 MG CAPSULE [Ribasphere] ![Compare how all Medicare Part D PDP plans in WI cover RIBAVIRIN 200 MG CAPSULE [Ribasphere].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RIBAVIRIN 200 MG TABLET [Ribasphere] ![Compare how all Medicare Part D PDP plans in WI cover RIBAVIRIN 200 MG TABLET [Ribasphere].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RIDAURA 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIDAURA 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | None |
RIFABUTIN 150 MG CAPSULE [Mycobutin] ![Compare how all Medicare Part D PDP plans in WI cover RIFABUTIN 150 MG CAPSULE [Mycobutin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIFAMPIN 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIFAMPIN 300 MG CAPSULE [Rimactane] ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN 300 MG CAPSULE [Rimactane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIFAMPIN IV 600 MG VIAL [Rifadin] ![Compare how all Medicare Part D PDP plans in WI cover RIFAMPIN IV 600 MG VIAL [Rifadin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RILUZOLE 50 MG TABLET [Rilutek] ![Compare how all Medicare Part D PDP plans in WI cover RILUZOLE 50 MG TABLET [Rilutek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
Rimantadine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Rimantadine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RINVOQ ER 15 MG TABLET ER 24H ![Compare how all Medicare Part D PDP plans in WI cover RINVOQ ER 15 MG TABLET ER 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RINVOQ ER 30 MG TABLET 24H ![Compare how all Medicare Part D PDP plans in WI cover RINVOQ ER 30 MG TABLET 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RINVOQ ER 45 MG TABLET ER 24H ![Compare how all Medicare Part D PDP plans in WI cover RINVOQ ER 45 MG TABLET ER 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RISEDRONATE SODIUM 150 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 150 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISEDRONATE SODIUM 30 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 30 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISEDRONATE SODIUM 5 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in WI cover RISEDRONATE SODIUM 5 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | None |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RISPERIDONE 0.25 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.25 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RISPERIDONE 0.5 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.5 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RISPERIDONE 0.5 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 0.5 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RISPERIDONE 1 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RISPERIDONE 1 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RISPERIDONE 1 MG/ML SOLUTION [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 1 MG/ML SOLUTION [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RISPERIDONE 2 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 2 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RISPERIDONE 2 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 2 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RISPERIDONE 3 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 3 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE 3 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 3 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RISPERIDONE 4 MG ODT TABLET RAPDIS [Risperdal M-Tab] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 4 MG ODT TABLET RAPDIS [Risperdal M-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RISPERIDONE 4 MG TABLET [Risperdal] ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE 4 MG TABLET [Risperdal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in WI cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
RITONAVIR 100 MG TABLET [Norvir] ![Compare how all Medicare Part D PDP plans in WI cover RITONAVIR 100 MG TABLET [Norvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RIVASTIGMINE 1.5 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 1.5 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIVASTIGMINE 13.3 MG/24HR PTCH PATCH [Exelon Patch] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 13.3 MG/24HR PTCH PATCH [Exelon Patch].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIVASTIGMINE 3 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 3 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIVASTIGMINE 4.5 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 4.5 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIVASTIGMINE 4.6 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 4.6 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIVASTIGMINE 6 MG CAPSULE [Exelon] ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 6 MG CAPSULE [Exelon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIVASTIGMINE 9.5 MG/24HR PATCH ![Compare how all Medicare Part D PDP plans in WI cover RIVASTIGMINE 9.5 MG/24HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
RIZATRIPTAN 10 MG ODT [Maxalt-MLT] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 10 MG ODT [Maxalt-MLT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:12 /30Days |
RIZATRIPTAN 10 MG TABLET [Maxalt] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 10 MG TABLET [Maxalt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | Q:12 /30Days |
RIZATRIPTAN 5 MG ODT TABLET RAPDIS [Maxalt-MLT] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 5 MG ODT TABLET RAPDIS [Maxalt-MLT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:12 /30Days |
RIZATRIPTAN 5 MG TABLET [Maxalt] ![Compare how all Medicare Part D PDP plans in WI cover RIZATRIPTAN 5 MG TABLET [Maxalt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | Q:12 /30Days |
ROCKLATAN 0.02%-0.005% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover ROCKLATAN 0.02%-0.005% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
ROPINIROLE HCL 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
ROPINIROLE HCL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
ROPINIROLE HCL 1 MG TABLET [Requip] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 1 MG TABLET [Requip].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
ROPINIROLE HCL 2 MG TABLET [Requip] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 2 MG TABLET [Requip].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
ROPINIROLE HCL 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE HCL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
ROPINIROLE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$9.00 | $18.00 | None |
ROPINIROLE HCL ER 12 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 12 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
ROPINIROLE HCL ER 2 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 2 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
ROPINIROLE HCL ER 4 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 4 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
ROPINIROLE HCL ER 6 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 6 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
ROPINIROLE HCL ER 8 MG TABLET ER 24H [Requip XL] ![Compare how all Medicare Part D PDP plans in WI cover ROPINIROLE HCL ER 8 MG TABLET ER 24H [Requip XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
ROSUVASTATIN CALCIUM 40 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 40 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor] ![Compare how all Medicare Part D PDP plans in WI cover ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROTARIX VACCINE SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover ROTARIX VACCINE SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
ROTATEQ VACCINE SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ROTATEQ VACCINE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
ROZLYTREK 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ROZLYTREK 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
ROZLYTREK 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ROZLYTREK 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUBRACA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUBRACA 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUBRACA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RUBRACA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUCONEST 2,100 UNIT VIAL ![Compare how all Medicare Part D PDP plans in WI cover RUCONEST 2,100 UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUFINAMIDE 200 MG TABLET [Banzel] ![Compare how all Medicare Part D PDP plans in WI cover RUFINAMIDE 200 MG TABLET [Banzel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUFINAMIDE 40 MG/ML ORAL SUSPENSION [Banzel] ![Compare how all Medicare Part D PDP plans in WI cover RUFINAMIDE 40 MG/ML ORAL SUSPENSION [Banzel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RUFINAMIDE 400 MG TABLET [Banzel] ![Compare how all Medicare Part D PDP plans in WI cover RUFINAMIDE 400 MG TABLET [Banzel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RUKOBIA ER 600 MG TABLETLET ER 12H ![Compare how all Medicare Part D PDP plans in WI cover RUKOBIA ER 600 MG TABLETLET ER 12H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | None |
RYBELSUS 14 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYBELSUS 14 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
RYBELSUS 3 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYBELSUS 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
RYBELSUS 7 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover RYBELSUS 7 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
RYDAPT 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover RYDAPT 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
29% | N/A | P |
RYTARY ER 23.75 MG-95 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 23.75 MG-95 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | S |
RYTARY ER 36.25 MG-145 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 36.25 MG-145 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | S |
RYTARY ER 48.75 MG-195 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 48.75 MG-195 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | S |
RYTARY ER 61.25 MG-245 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover RYTARY ER 61.25 MG-245 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | S |