2022 Medicare Part D Plan Formulary Information |
Network PlatinumChoice (PPO) (H5215-011-0)
Benefit Details
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The Network PlatinumChoice (PPO) (H5215-011-0) Formulary Drugs Starting with the Letter F in Calumet County, WI: CMS MA Region 14 which includes: WI
|
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 |
FABIOR 0.1% FOAM ![Compare how all Medicare Part D PDP plans in WI cover FABIOR 0.1% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P |
FALMINA-28 TABLET [Vienva] ![Compare how all Medicare Part D PDP plans in WI cover FALMINA-28 TABLET [Vienva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FAMCICLOVIR 125 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FAMCICLOVIR 125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:10 /5Days |
FAMCICLOVIR 250 MG TABLET [Famvir] ![Compare how all Medicare Part D PDP plans in WI cover FAMCICLOVIR 250 MG TABLET [Famvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:60 /30Days |
FAMCICLOVIR 500 MG TABLET [Famvir] ![Compare how all Medicare Part D PDP plans in WI cover FAMCICLOVIR 500 MG TABLET [Famvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:30 /10Days |
FAMOTIDINE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FAMOTIDINE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FAMOTIDINE 40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FAMOTIDINE 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FANAPT 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S |
FANAPT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 12 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
FANAPT 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S |
FANAPT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S |
FANAPT 6 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
FANAPT 8 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FANAPT 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
FANAPT TITR TABLETS ![Compare how all Medicare Part D PDP plans in WI cover FANAPT TITR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S |
FARESTON 60 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FARESTON 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FARXIGA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FARXIGA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P Q:30 /30Days |
FARXIGA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FARXIGA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P Q:60 /30Days |
FASENRA 30 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FASENRA 30 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
FASENRA PEN 30 MG/ML AUTO INJCT ![Compare how all Medicare Part D PDP plans in WI cover FASENRA PEN 30 MG/ML AUTO INJCT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FEBUXOSTAT 40 MG TABLET [Uloric] ![Compare how all Medicare Part D PDP plans in WI cover FEBUXOSTAT 40 MG TABLET [Uloric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FEBUXOSTAT 80 MG TABLET [Uloric] ![Compare how all Medicare Part D PDP plans in WI cover FEBUXOSTAT 80 MG TABLET [Uloric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FELBAMATE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FELBAMATE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FELBAMATE 600 MG TABLET [Felbatol] ![Compare how all Medicare Part D PDP plans in WI cover FELBAMATE 600 MG TABLET [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol] ![Compare how all Medicare Part D PDP plans in WI cover FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FELBATOL 400MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FELBATOL 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
FELBATOL 600 MG/5 ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover FELBATOL 600 MG/5 ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
FELBATOL 600MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FELBATOL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S |
FELDENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FELDENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FELDENE 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FELDENE 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FELODIPINE ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FELODIPINE ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil] ![Compare how all Medicare Part D PDP plans in WI cover FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FELODIPINE ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FELODIPINE ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FEMARA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FEMARA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FEMRING 0.05 MG/DAY VAGINAL RING ![Compare how all Medicare Part D PDP plans in WI cover FEMRING 0.05 MG/DAY VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FEMRING 0.10 MG/DAY VAGINAL RING ![Compare how all Medicare Part D PDP plans in WI cover FEMRING 0.10 MG/DAY VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FEMYNOR 28 TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in WI cover FEMYNOR 28 TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 120 MG TABLET [Fenoglide] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 120 MG TABLET [Fenoglide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOFIBRATE 130 MG CAPSULE [Antara] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 130 MG CAPSULE [Antara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOFIBRATE 134 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 134 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 145 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 145 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 150 MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 150 MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOFIBRATE 160 MG TABLET [Triglide] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 160 MG TABLET [Triglide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 200 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 200 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 30 MG CAPSULE [Antara] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 30 MG CAPSULE [Antara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOFIBRATE 40 MG TABLET [Fenoglide] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 40 MG TABLET [Fenoglide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOFIBRATE 43 MG CAPSULE [Antara] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 43 MG CAPSULE [Antara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 48 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 48 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 50 MG CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 50 MG CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOFIBRATE 50 MG ORAL CAPSULE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 50 MG ORAL CAPSULE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOFIBRATE 54 MG 90 TABLET BOTTLE [LIPOFEN] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 54 MG 90 TABLET BOTTLE [LIPOFEN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 67 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 67 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRATE 90 MG CAPSULE [Antara] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRATE 90 MG CAPSULE [Antara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENOFIBRIC ACID DR 135 MG CAPSULE DR [Trilipix] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRIC ACID DR 135 MG CAPSULE DR [Trilipix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOFIBRIC ACID DR 45 MG CAPSULE [Trilipix] ![Compare how all Medicare Part D PDP plans in WI cover FENOFIBRIC ACID DR 45 MG CAPSULE [Trilipix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FENOGLIDE 120 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FENOGLIDE 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENOGLIDE 40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FENOGLIDE 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FENTANYL 100 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 100 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:10 /30Days |
FENTANYL 12 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 12 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:10 /30Days |
FENTANYL 25 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 25 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:10 /30Days |
FENTANYL 37.5 MCG/HR PATCH TD72 ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 37.5 MCG/HR PATCH TD72.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:10 /30Days |
FENTANYL 50 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 50 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:10 /30Days |
FENTANYL 62.5 MCG/HR PATCH TD72 ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 62.5 MCG/HR PATCH TD72.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:10 /30Days |
FENTANYL 75 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 75 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:10 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL 87.5 MCG/HR PATCH TD72 ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL 87.5 MCG/HR PATCH TD72.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:10 /30Days |
FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P Q:120 /30Days |
FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in WI cover FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:120 /30Days |
FERRIPROX 1,000 MG (3X/DAY) TABLET ![Compare how all Medicare Part D PDP plans in WI cover FERRIPROX 1,000 MG (3X/DAY) TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FERRIPROX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover FERRIPROX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FERRIPROX 500 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FERRIPROX 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FESOTERODINE ER 4 MG TABLET 24H [Toviaz] ![Compare how all Medicare Part D PDP plans in WI cover FESOTERODINE ER 4 MG TABLET 24H [Toviaz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FESOTERODINE ER 8 MG TABLET 24H [Toviaz] ![Compare how all Medicare Part D PDP plans in WI cover FESOTERODINE ER 8 MG TABLET 24H [Toviaz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FETZIMA 20-40 MG TITRATION PAK ![Compare how all Medicare Part D PDP plans in WI cover FETZIMA 20-40 MG TITRATION PAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FETZIMA ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FETZIMA ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FETZIMA ER 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FETZIMA ER 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FETZIMA ER 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FETZIMA ER 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FETZIMA ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FETZIMA ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FEXMID 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FEXMID 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN ![Compare how all Medicare Part D PDP plans in WI cover FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FIASP 100 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover FIASP 100 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FIASP PENFILL 100 UNIT/ML CART CARTRIDGE ![Compare how all Medicare Part D PDP plans in WI cover FIASP PENFILL 100 UNIT/ML CART CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FINACEA 15% FOAM ![Compare how all Medicare Part D PDP plans in WI cover FINACEA 15% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FINACEA 15% GEL ![Compare how all Medicare Part D PDP plans in WI cover FINACEA 15% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FINASTERIDE 5 MG TABLET [Proscar] ![Compare how all Medicare Part D PDP plans in WI cover FINASTERIDE 5 MG TABLET [Proscar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FINTEPLA 2.2 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover FINTEPLA 2.2 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:360 /30Days |
FIORICET 50-300-40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FIORICET 50-300-40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:180 /30Days |
Fioricet/Codeine 50-300-40-30 CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover Fioricet/Codeine 50-300-40-30 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:180 /30Days |
FIRAZYR 30 MG/3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FIRAZYR 30 MG/3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:27 /30Days |
FIRDAPSE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FIRDAPSE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
FIRMAGON 2 X 120 MG KIT ![Compare how all Medicare Part D PDP plans in WI cover FIRMAGON 2 X 120 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P |
FIRMAGON 80 MG KIT ![Compare how all Medicare Part D PDP plans in WI cover FIRMAGON 80 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P |
FLAC OTIC OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in WI cover FLAC OTIC OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLAGYL 375MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FLAGYL 375MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLAREX 0.1% EYE DROPS EYE DROPPER ![Compare how all Medicare Part D PDP plans in WI cover FLAREX 0.1% EYE DROPS EYE DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FLAVOXATE HCL 100 MG TABLET [Urispas] ![Compare how all Medicare Part D PDP plans in WI cover FLAVOXATE HCL 100 MG TABLET [Urispas].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLEBOGAMMA DIF 10% VIAL ![Compare how all Medicare Part D PDP plans in WI cover FLEBOGAMMA DIF 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
FLECAINIDE ACETATE 100 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in WI cover FLECAINIDE ACETATE 100 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLECAINIDE ACETATE 150 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in WI cover FLECAINIDE ACETATE 150 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLECAINIDE ACETATE 50 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in WI cover FLECAINIDE ACETATE 50 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLECTOR 1.3% PATCH TD12 ![Compare how all Medicare Part D PDP plans in WI cover FLECTOR 1.3% PATCH TD12.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P |
FLOLIPID 20 MG/5 ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover FLOLIPID 20 MG/5 ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FLOLIPID 40 MG/5 ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover FLOLIPID 40 MG/5 ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FLOMAX 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FLOMAX 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in WI cover FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in WI cover FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
FLOVENT DISKUS POWDER 50MCG 60 CTR ![Compare how all Medicare Part D PDP plans in WI cover FLOVENT DISKUS POWDER 50MCG 60 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:60 /30Days |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in WI cover FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:24 /30Days |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in WI cover FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:24 /30Days |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER ![Compare how all Medicare Part D PDP plans in WI cover FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:11 /30Days |
FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCONAZOLE 100 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE 100 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCONAZOLE 150 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE 150 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCONAZOLE 200 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE 200 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCONAZOLE 50 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE 50 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $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 WI cover FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in WI cover FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUCYTOSINE 250 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in WI cover FLUCYTOSINE 250 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FLUCYTOSINE 500 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in WI cover FLUCYTOSINE 500 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FLUDROCORTISONE 0.1 MG TABLET [Florinef] ![Compare how all Medicare Part D PDP plans in WI cover FLUDROCORTISONE 0.1 MG TABLET [Florinef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL ![Compare how all Medicare Part D PDP plans in WI cover FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:50 /30Days |
FLUOCINOLONE 0.01% CREAM (G) ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINOLONE 0.01% CREAM (G).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FLUOCINOLONE 0.01% SCALP OIL [Derma-Smoothe/FS] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINOLONE 0.01% SCALP OIL [Derma-Smoothe/FS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FLUOCINOLONE 0.01% SOLUTION [Synalar] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINOLONE 0.01% SOLUTION [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FLUOCINOLONE 0.025% CREAM (G) [Synalar] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINOLONE 0.025% CREAM (G) [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FLUOCINOLONE 0.025% OINTMENT [Synalar] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINOLONE 0.025% OINTMENT [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINOLONE OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINOLONE OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOCINONIDE 0.05% CREAM (G) [Lidex] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINONIDE 0.05% CREAM (G) [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOCINONIDE 0.05% GEL [Lidex] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINONIDE 0.05% GEL [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOCINONIDE 0.05% OINTMENT [Lidex] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINONIDE 0.05% OINTMENT [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOCINONIDE 0.05% SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINONIDE 0.05% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOCINONIDE 0.1% CREAM (g) [Vanos] ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINONIDE 0.1% CREAM (g) [Vanos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FLUOCINONIDE-E 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WI cover FLUOCINONIDE-E 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
Fluorometholone 0.1% drops ![Compare how all Medicare Part D PDP plans in WI cover Fluorometholone 0.1% drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOROURACIL 0.5% CREAM (G) [Carac] ![Compare how all Medicare Part D PDP plans in WI cover FLUOROURACIL 0.5% CREAM (G) [Carac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FLUOROURACIL 2% TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover FLUOROURACIL 2% TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOROURACIL 5% CREAM (g) [Efudex] ![Compare how all Medicare Part D PDP plans in WI cover FLUOROURACIL 5% CREAM (g) [Efudex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOROURACIL 5% TOPICAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover FLUOROURACIL 5% TOPICAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE 20 MG/5 ML SOLUTION [Prozac] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE 20 MG/5 ML SOLUTION [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE DR 90 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE DR 90 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE HCL 10 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 10 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FLUOXETINE HCL 10 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 10 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE HCL 10 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 10 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE HCL 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FLUOXETINE HCL 20 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 20 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE HCL 20 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 20 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUOXETINE HCL 40 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 40 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FLUOXETINE HCL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FLUOXETINE HCL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE 10 MG TABLET [Prolixin] ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 10 MG TABLET [Prolixin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE 2.5 MG/5 ML ELIXIR [Prolixin] ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 2.5 MG/5 ML ELIXIR [Prolixin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE 5MG/ML CONC ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE 5MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate] ![Compare how all Medicare Part D PDP plans in WI cover FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLURANDRENOLIDE 0.05% CREAM (G) [Nolix] ![Compare how all Medicare Part D PDP plans in WI cover FLURANDRENOLIDE 0.05% CREAM (G) [Nolix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:120 /30Days |
FLURANDRENOLIDE 0.05% LOTION [Nolix] ![Compare how all Medicare Part D PDP plans in WI cover FLURANDRENOLIDE 0.05% LOTION [Nolix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:120 /30Days |
FLURANDRENOLIDE 0.05% OINTMENT [Cordran] ![Compare how all Medicare Part D PDP plans in WI cover FLURANDRENOLIDE 0.05% OINTMENT [Cordran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Flurazepam Hydrochloride 15mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Flurazepam Hydrochloride 15mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
Flurazepam Hydrochloride 30mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Flurazepam Hydrochloride 30mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | None |
FLURBIPROFEN 0.03% EYE DROPS [Ocufen] ![Compare how all Medicare Part D PDP plans in WI cover FLURBIPROFEN 0.03% EYE DROPS [Ocufen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $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 WI 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 |
$8.00 | $0.00 | None |
FLUTICASONE PROP 0.005% OINTMENT [Cutivate] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE PROP 0.005% OINTMENT [Cutivate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUTICASONE PROP 0.05% LOTION [Cutivate] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE PROP 0.05% LOTION [Cutivate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI 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 |
$8.00 | $0.00 | None |
FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:16 /30Days |
FLUTICASONE-SALMETEROL 100-50 INHALER [Advair] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE-SALMETEROL 100-50 INHALER [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:60 /30Days |
FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:1 /30Days |
FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:1 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUTICASONE-SALMETEROL 250-50 INHALER [Advair] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE-SALMETEROL 250-50 INHALER [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:60 /30Days |
FLUTICASONE-SALMETEROL 500-50 INHALER [Advair] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE-SALMETEROL 500-50 INHALER [Advair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:60 /30Days |
FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in WI cover FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:1 /30Days |
FLUVASTATIN ER 80 MG TABLET ER 24H [Lescol XL] ![Compare how all Medicare Part D PDP plans in WI cover FLUVASTATIN ER 80 MG TABLET ER 24H [Lescol XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in WI cover FLUVASTATIN SODIUM 20 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol] ![Compare how all Medicare Part D PDP plans in WI cover FLUVASTATIN SODIUM 40 MG CAPSULE [Lescol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUVOXAMINE ER 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FLUVOXAMINE ER 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FLUVOXAMINE ER 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FLUVOXAMINE ER 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FLUVOXAMINE MALEATE 100 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in WI cover FLUVOXAMINE MALEATE 100 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUVOXAMINE MALEATE 25 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in WI cover FLUVOXAMINE MALEATE 25 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FLUVOXAMINE MALEATE 50 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in WI cover FLUVOXAMINE MALEATE 50 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FML FORTE 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover FML FORTE 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FML LIQUIFILM 0.1% EYE DROP ![Compare how all Medicare Part D PDP plans in WI cover FML LIQUIFILM 0.1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FML S.O.P. 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover FML S.O.P. 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN XR 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN XR 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN XR 15MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN XR 15MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN XR 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN XR 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Focalin XR 25mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Focalin XR 25mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN XR 30MG CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN XR 30MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Focalin XR 35mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Focalin XR 35mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Focalin XR 40mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Focalin XR 40mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FOCALIN XR 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FOCALIN XR 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FONDAPARINUX 2.5 MG/0.5 ML SYR SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover FONDAPARINUX 2.5 MG/0.5 ML SYR SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:15 /30Days |
FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
Fondaparinux sodium 10 MG per 0.8 ML Prefilled Syringe [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover Fondaparinux sodium 10 MG per 0.8 ML Prefilled Syringe [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
Fondaparinux sodium 2.5 MG in 0.5 ML Prefilled Syringe Prefilled Syringe [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover Fondaparinux sodium 2.5 MG in 0.5 ML Prefilled Syringe Prefilled Syringe [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:15 /30Days |
Fondaparinux sodium 5 MG in 0.4 ML Prefilled Syringe [Arixtra] ![Compare how all Medicare Part D PDP plans in WI cover Fondaparinux sodium 5 MG in 0.4 ML Prefilled Syringe [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FORFIVO XL 450 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FORFIVO XL 450 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FORMOTEROL 20 MCG/2 ML VIAL-NEB [Perforomist] ![Compare how all Medicare Part D PDP plans in WI cover FORMOTEROL 20 MCG/2 ML VIAL-NEB [Perforomist].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$42.00 | $105.00 | P |
Forteo 250ug/mL 1 SYRINGE per CARTON / 2.4 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in WI 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 |
28% | N/A | P Q:2 /28Days |
FORTESTA 10mg/0.5g ![Compare how all Medicare Part D PDP plans in WI cover FORTESTA 10mg/0.5g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | P |
FOSAMAX 70 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOSAMAX 70 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S Q:5 /30Days |
FOSAMAX PLUS D 70 MG-2800 UNIT TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOSAMAX PLUS D 70 MG-2800 UNIT TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S Q:5 /30Days |
FOSAMAX PLUS D 70 MG-5600 UNIT TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOSAMAX PLUS D 70 MG-5600 UNIT TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S Q:5 /30Days |
FOSAMPRENAVIR 700 MG TABLET [Lexiva] ![Compare how all Medicare Part D PDP plans in WI cover FOSAMPRENAVIR 700 MG TABLET [Lexiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:180 /30Days |
FOSFOMYCIN 3 GM SACHET PACKET [Monurol] ![Compare how all Medicare Part D PDP plans in WI cover FOSFOMYCIN 3 GM SACHET PACKET [Monurol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FOSINOPRIL SODIUM 10 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in WI cover FOSINOPRIL SODIUM 10 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FOSINOPRIL SODIUM 20 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in WI cover FOSINOPRIL SODIUM 20 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FOSINOPRIL SODIUM 40 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in WI cover FOSINOPRIL SODIUM 40 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in WI cover FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in WI cover FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FOSRENOL 1,000 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOSRENOL 1,000 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FOSRENOL 1,000 MG POWDER PACK ![Compare how all Medicare Part D PDP plans in WI cover FOSRENOL 1,000 MG POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FOSRENOL 500 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOSRENOL 500 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FOSRENOL 750 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover FOSRENOL 750 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FOSRENOL 750 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover FOSRENOL 750 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FOTIVDA 0.89 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FOTIVDA 0.89 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
FOTIVDA 1.34 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover FOTIVDA 1.34 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
FRAGMIN 10,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 10,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FRAGMIN 12,500 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 12,500 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FRAGMIN 15,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 15,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FRAGMIN 18,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 18,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FRAGMIN 2,500 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 2,500 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:6 /30Days |
FRAGMIN 5,000 UNITS SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 5,000 UNITS SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | Q:6 /30Days |
FRAGMIN 7,500 UNITS/0.3 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 7,500 UNITS/0.3 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:9 /30Days |
FRAGMIN 95,000 UNITS/3.8 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover FRAGMIN 95,000 UNITS/3.8 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FROVA 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FROVA 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S Q:27 /28Days |
FROVATRIPTAN SUCC 2.5 MG TABLET [Frova] ![Compare how all Medicare Part D PDP plans in WI cover FROVATRIPTAN SUCC 2.5 MG TABLET [Frova].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | Q:27 /28Days |
FULPHILA 6 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover FULPHILA 6 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FUROSEMIDE 10 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover FUROSEMIDE 10 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FUROSEMIDE 100 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover FUROSEMIDE 100 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 WI 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 |
$8.00 | $0.00 | None |
FUROSEMIDE 20 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in WI cover FUROSEMIDE 20 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FUROSEMIDE 40 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in WI cover FUROSEMIDE 40 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FUROSEMIDE 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in WI cover FUROSEMIDE 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FUROSEMIDE 80 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in WI cover FUROSEMIDE 80 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $0.00 | None |
FUZEON 90 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover FUZEON 90 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
FYAVOLV 0.5 MG-2.5 MCG TABLET [Jevantique] ![Compare how all Medicare Part D PDP plans in WI cover FYAVOLV 0.5 MG-2.5 MCG TABLET [Jevantique].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FYAVOLV 1 MG-5 MCG TABLET [Jinteli 1/5] ![Compare how all Medicare Part D PDP plans in WI cover FYAVOLV 1 MG-5 MCG TABLET [Jinteli 1/5].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$8.00 | $0.00 | None |
FYCOMPA 0.5 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 0.5 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:720 /30Days |
FYCOMPA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
FYCOMPA 12 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 12 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FYCOMPA 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $237.00 | S Q:30 /30Days |
FYCOMPA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
FYCOMPA 6 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |
FYCOMPA 8 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover FYCOMPA 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | S Q:30 /30Days |