2022 Medicare Part D Plan Formulary Information |
Premera Blue Cross Medicare Advantage (HMO) (H7245-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Premera Blue Cross Medicare Advantage (HMO). 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 Premera Blue Cross Medicare Advantage (HMO) (H7245-001-0) Formulary Drugs Starting with the Letter I in Thurston County, WA: CMS MA Region 23 which includes: WA
|
Drugs Starting with Letter I
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
IBANDRONATE SODIUM 150 MG TABLET [Boniva] ![Compare how all Medicare Part D PDP plans in WA cover IBANDRONATE SODIUM 150 MG TABLET [Boniva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
IBRANCE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover IBRANCE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:21 /28Days |
IBRANCE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IBRANCE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:21 /28Days |
IBRANCE 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover IBRANCE 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:21 /28Days |
IBRANCE 125 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IBRANCE 125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:21 /28Days |
IBRANCE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover IBRANCE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:21 /28Days |
IBRANCE 75 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IBRANCE 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:21 /28Days |
IBSRELA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IBSRELA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
IBU 600 MG TABLET [Toxicology Saliva Collection] ![Compare how all Medicare Part D PDP plans in WA cover IBU 600 MG TABLET [Toxicology Saliva Collection].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
IBU 800 MG TABLET [Samson-8] ![Compare how all Medicare Part D PDP plans in WA cover IBU 800 MG TABLET [Samson-8].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [PediaCare Children's Pain Reliever/Fever Reducer IB] ![Compare how all Medicare Part D PDP plans in WA cover IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [PediaCare Children's Pain Reliever/Fever Reducer IB].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
IBUPROFEN 400 MG TABLET [Motrin] ![Compare how all Medicare Part D PDP plans in WA cover IBUPROFEN 400 MG TABLET [Motrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
IBUPROFEN 600 MG TABLET [Toxicology Saliva Collection] ![Compare how all Medicare Part D PDP plans in WA cover IBUPROFEN 600 MG TABLET [Toxicology Saliva Collection].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
IBUPROFEN 800 MG TABLET [Samson-8] ![Compare how all Medicare Part D PDP plans in WA cover IBUPROFEN 800 MG TABLET [Samson-8].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ICATIBANT 30 MG/3 ML SYRINGE [FIRAZYR] ![Compare how all Medicare Part D PDP plans in WA cover ICATIBANT 30 MG/3 ML SYRINGE [FIRAZYR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:27 /30Days |
ICLEVIA 0.15 MG-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in WA cover ICLEVIA 0.15 MG-0.03 MG TABLET TBDSPK 3MO [Setlakin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ICLUSIG 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ICLUSIG 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
ICLUSIG 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ICLUSIG 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
ICLUSIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ICLUSIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
ICLUSIG 45 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ICLUSIG 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
IDHIFA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IDHIFA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IDHIFA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IDHIFA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
ILEVRO 0.3% OPHTH DROPS EYE DROPPER ![Compare how all Medicare Part D PDP plans in WA cover ILEVRO 0.3% OPHTH DROPS EYE DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
IMATINIB MESYLATE 100 MG TABLET [Gleevec] ![Compare how all Medicare Part D PDP plans in WA cover IMATINIB MESYLATE 100 MG TABLET [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:90 /30Days |
IMATINIB MESYLATE 400 MG TABLET [Gleevec] ![Compare how all Medicare Part D PDP plans in WA cover IMATINIB MESYLATE 400 MG TABLET [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:60 /30Days |
IMBRUVICA 140 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover IMBRUVICA 140 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:120 /30Days |
IMBRUVICA 140 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IMBRUVICA 140 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
IMBRUVICA 280 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IMBRUVICA 280 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
IMBRUVICA 420 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IMBRUVICA 420 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
IMBRUVICA 560 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IMBRUVICA 560 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
IMBRUVICA 70 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover IMBRUVICA 70 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
IMIPRAMINE HCL 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE HCL 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMIPRAMINE HCL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE HCL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
IMIPRAMINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
IMIPRAMINE PAMOATE 100 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE PAMOATE 100 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
IMIPRAMINE PAMOATE 125 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE PAMOATE 125 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
IMIPRAMINE PAMOATE 150 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE PAMOATE 150 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
IMIPRAMINE PAMOATE 75 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in WA cover IMIPRAMINE PAMOATE 75 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
IMIQUIMOD 5% CREAM PACKET ![Compare how all Medicare Part D PDP plans in WA cover IMIQUIMOD 5% CREAM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | Q:24 /30Days |
IMOVAX RABIES VACCINE VIAL ![Compare how all Medicare Part D PDP plans in WA cover IMOVAX RABIES VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | P |
IMVEXXY 10 MCG MAINTENANCE PAK INSERT ![Compare how all Medicare Part D PDP plans in WA cover IMVEXXY 10 MCG MAINTENANCE PAK INSERT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
IMVEXXY 10 MCG STARTER PACK INSR DS PK ![Compare how all Medicare Part D PDP plans in WA cover IMVEXXY 10 MCG STARTER PACK INSR DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
IMVEXXY 4 MCG MAINTENANCE PACK INSERT ![Compare how all Medicare Part D PDP plans in WA cover IMVEXXY 4 MCG MAINTENANCE PACK INSERT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMVEXXY 4 MCG STARTER PACK INSR DS PK ![Compare how all Medicare Part D PDP plans in WA cover IMVEXXY 4 MCG STARTER PACK INSR DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
INBRIJA 42 MG INHALATION CAPSULE W/DEV ![Compare how all Medicare Part D PDP plans in WA cover INBRIJA 42 MG INHALATION CAPSULE W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:300 /30Days |
INCASSIA 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in WA cover INCASSIA 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WA cover Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
INCRUSE ELLIPTA 62.5 MCG INH ![Compare how all Medicare Part D PDP plans in WA cover INCRUSE ELLIPTA 62.5 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
INDAPAMIDE 1.25 MG TABLET [Lozol] ![Compare how all Medicare Part D PDP plans in WA cover INDAPAMIDE 1.25 MG TABLET [Lozol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
INDAPAMIDE 2.5 MG TABLET [Lozol] ![Compare how all Medicare Part D PDP plans in WA cover INDAPAMIDE 2.5 MG TABLET [Lozol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
INFANRIX DTAP SYRINGE ![Compare how all Medicare Part D PDP plans in WA cover INFANRIX DTAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
INGREZZA 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover INGREZZA 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
INGREZZA 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover INGREZZA 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
INGREZZA 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover INGREZZA 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INGREZZA INITIATION PACK CAPSULE DS PK ![Compare how all Medicare Part D PDP plans in WA cover INGREZZA INITIATION PACK CAPSULE DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:28 /28Days |
INLYTA 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INLYTA 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:180 /30Days |
INLYTA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INLYTA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:120 /30Days |
INQOVI 35 MG-100 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INQOVI 35 MG-100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
INREBIC 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WA cover INREBIC 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
INSULIN ASPART 100 UNIT/ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in WA cover INSULIN ASPART 100 UNIT/ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN ASPART 100 UNIT/ML INSULIN PEN [NovoLog PenFill] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN ASPART 100 UNIT/ML INSULIN PEN [NovoLog PenFill].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN ASPART 100 UNIT/ML VIAL [NovoLog PenFill] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN ASPART 100 UNIT/ML VIAL [NovoLog PenFill].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN ASPART PROT-INSULN ASP INSULIN PEN [NovoLog Mix 70/30] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN ASPART PROT-INSULN ASP INSULIN PEN [NovoLog Mix 70/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN ASPART PROT-INSULN ASP VIAL [NovoLog Mix 70/30] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN ASPART PROT-INSULN ASP VIAL [NovoLog Mix 70/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN LISPRO 100 UNIT/ML INSULN PEN [LYUMJEV] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN LISPRO 100 UNIT/ML INSULN PEN [LYUMJEV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INSULIN LISPRO 100 UNIT/ML VIAL [LYUMJEV] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN LISPRO 100 UNIT/ML VIAL [LYUMJEV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN LISPRO JR 100 UNIT/ML INSULN PEN HF ![Compare how all Medicare Part D PDP plans in WA cover INSULIN LISPRO JR 100 UNIT/ML INSULN PEN HF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INSULIN LISPRO MIX 75-25 KWIKPEN INSULN PEN [Humalog KwikPen Mix 75/25] ![Compare how all Medicare Part D PDP plans in WA cover INSULIN LISPRO MIX 75-25 KWIKPEN INSULN PEN [Humalog KwikPen Mix 75/25].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INTELENCE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INTELENCE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INTRALIPID 20% IV FAT EMULSION ![Compare how all Medicare Part D PDP plans in WA cover INTRALIPID 20% IV FAT EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
INTRALIPID 30% IV FAT EMULSION ![Compare how all Medicare Part D PDP plans in WA cover INTRALIPID 30% IV FAT EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
INTRAROSA 6.5 MG VAG INSERT ![Compare how all Medicare Part D PDP plans in WA cover INTRAROSA 6.5 MG VAG INSERT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
INTRON A 10 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in WA cover INTRON A 10 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | P |
INTRON A 18 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in WA cover INTRON A 18 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
INTRON A 50 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in WA cover INTRON A 50 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in WA cover INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Invega Sustenna 117 mg/0.75mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in WA cover Invega Sustenna 117 mg/0.75mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:1 /28Days |
Invega Sustenna 156 mg/mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in WA cover Invega Sustenna 156 mg/mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:1 /28Days |
Invega Sustenna 234 mg/1.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in WA cover Invega Sustenna 234 mg/1.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:2 /28Days |
Invega Sustenna 39 mg/0.25mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in WA cover Invega Sustenna 39 mg/0.25mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Invega Sustenna 78 mg/0.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in WA cover Invega Sustenna 78 mg/0.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:1 /28Days |
INVEGA TRINZA 273 MG/0.875 ML ![Compare how all Medicare Part D PDP plans in WA cover INVEGA TRINZA 273 MG/0.875 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:1 /90Days |
INVEGA TRINZA 410 MG/1.315 ML ![Compare how all Medicare Part D PDP plans in WA cover INVEGA TRINZA 410 MG/1.315 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:1 /90Days |
INVEGA TRINZA 546 MG/1.75 ML ![Compare how all Medicare Part D PDP plans in WA cover INVEGA TRINZA 546 MG/1.75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:2 /90Days |
INVEGA TRINZA 819 MG/2.625 ML ![Compare how all Medicare Part D PDP plans in WA cover INVEGA TRINZA 819 MG/2.625 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | Q:3 /90Days |
INVELTYS 1% EYE DROP EYE DROPPER ![Compare how all Medicare Part D PDP plans in WA cover INVELTYS 1% EYE DROP EYE DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
INVOKAMET 150-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET 150-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVOKAMET 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
INVOKAMET 50-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET 50-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
INVOKAMET 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:120 /30Days |
INVOKAMET XR 150-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET XR 150-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
INVOKAMET XR 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET XR 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
INVOKAMET XR 50-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET XR 50-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
INVOKAMET XR 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKAMET XR 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:120 /30Days |
INVOKANA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKANA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
INVOKANA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover INVOKANA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:30 /30Days |
IPOL VIAL 40;8;32; UNT ![Compare how all Medicare Part D PDP plans in WA cover IPOL VIAL 40;8;32; UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
IPRAT-ALBUT 0.5-3(2.5) MG/3 ML ![Compare how all Medicare Part D PDP plans in WA cover IPRAT-ALBUT 0.5-3(2.5) MG/3 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IPRATROPIUM 0.06% SPRAY ![Compare how all Medicare Part D PDP plans in WA cover IPRATROPIUM 0.06% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
IPRATROPIUM BR 0.02% SOLUTION [Atrovent] ![Compare how all Medicare Part D PDP plans in WA cover IPRATROPIUM BR 0.02% SOLUTION [Atrovent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
IPRATROPIUM BROMIDE NASAL SPRAY ![Compare how all Medicare Part D PDP plans in WA cover IPRATROPIUM BROMIDE NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
IRBESARTAN 150 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in WA cover IRBESARTAN 150 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | Q:30 /30Days |
IRBESARTAN 300 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in WA cover IRBESARTAN 300 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | Q:30 /30Days |
IRBESARTAN 75 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in WA cover IRBESARTAN 75 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | Q:30 /30Days |
IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in WA cover IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | Q:30 /30Days |
IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in WA cover IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | Q:30 /30Days |
IRESSA 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover IRESSA 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ISENTRESS 100 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in WA cover ISENTRESS 100 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
ISENTRESS 100 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WA cover ISENTRESS 100 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISENTRESS 25 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WA cover ISENTRESS 25 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
ISENTRESS 400MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISENTRESS 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
ISENTRESS HD 600 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISENTRESS HD 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
ISIBLOOM 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WA cover ISIBLOOM 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOLYTE P IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in WA cover ISOLYTE P IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
ISOLYTE S IV SOLUTION PH7.4 ![Compare how all Medicare Part D PDP plans in WA cover ISOLYTE S IV SOLUTION PH7.4.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
ISONIAZID 100 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISONIAZID 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISONIAZID 300 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISONIAZID 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISONIAZID 50MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in WA cover ISONIAZID 50MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOSORBIDE DINITRATE 10 MG TABLET [Wesorbide] ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE DINITRATE 10 MG TABLET [Wesorbide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOSORBIDE DINITRATE 20 MG TABLET [Wesorbide] ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE DINITRATE 20 MG TABLET [Wesorbide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOSORBIDE DN 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE DN 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOSORBIDE DN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE DN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOSORBIDE MN ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE MN ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISOSORBIDE MONONIT 10 MG TABLET [Monoket] ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE MONONIT 10 MG TABLET [Monoket].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISOSORBIDE MONONIT 20 MG TABLET [Monoket] ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE MONONIT 20 MG TABLET [Monoket].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISOSORBIDE MONONIT ER 60 MG TABLET ER 24H [Isotrate ER] ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE MONONIT ER 60 MG TABLET ER 24H [Isotrate ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT) ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$4.00 | $0.00 | None |
ISOSORBIDE-HYDRALAZINE 20-37.5 TABLET [BiDil] ![Compare how all Medicare Part D PDP plans in WA cover ISOSORBIDE-HYDRALAZINE 20-37.5 TABLET [BiDil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOTON GENTAMICIN 80MG/100ML ![Compare how all Medicare Part D PDP plans in WA cover ISOTON GENTAMICIN 80MG/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOTONIC GENTAMICIN 100 MG/100 ML ![Compare how all Medicare Part D PDP plans in WA cover ISOTONIC GENTAMICIN 100 MG/100 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISOTONIC GENTAMICIN 80 MG/50 ML ![Compare how all Medicare Part D PDP plans in WA cover ISOTONIC GENTAMICIN 80 MG/50 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOTRETINOIN 10 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in WA cover ISOTRETINOIN 10 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
ISOTRETINOIN 20 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in WA cover ISOTRETINOIN 20 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
ISOTRETINOIN 30 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in WA cover ISOTRETINOIN 30 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
ISOTRETINOIN 40 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in WA cover ISOTRETINOIN 40 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
ISRADIPINE 2.5 MG CAPSULE [DynaCirc] ![Compare how all Medicare Part D PDP plans in WA cover ISRADIPINE 2.5 MG CAPSULE [DynaCirc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ISRADIPINE 5 MG CAPSULE [DynaCirc] ![Compare how all Medicare Part D PDP plans in WA cover ISRADIPINE 5 MG CAPSULE [DynaCirc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | None |
ITRACONAZOLE 10 MG/ML SOLUTION [Sporanox] ![Compare how all Medicare Part D PDP plans in WA cover ITRACONAZOLE 10 MG/ML SOLUTION [Sporanox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
ITRACONAZOLE 100 MG CAPSULE [Sporanox] ![Compare how all Medicare Part D PDP plans in WA cover ITRACONAZOLE 100 MG CAPSULE [Sporanox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
IVERMECTIN 3 MG TABLET [Stromectol, Sklice] ![Compare how all Medicare Part D PDP plans in WA cover IVERMECTIN 3 MG TABLET [Stromectol, Sklice].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$12.00 | $36.00 | P |
Ixekizumab 1ML 80 MG/ML Auto-Injector [Taltz] ![Compare how all Medicare Part D PDP plans in WA cover Ixekizumab 1ML 80 MG/ML Auto-Injector [Taltz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:3 /28Days |
Ixekizumab 1ML 80 MG/ML Prefilled Syringe [Taltz] ![Compare how all Medicare Part D PDP plans in WA cover Ixekizumab 1ML 80 MG/ML Prefilled Syringe [Taltz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:3 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IXIARO 6 UNIT(6 MCG)/0.5ML SYRINGE ![Compare how all Medicare Part D PDP plans in WA cover IXIARO 6 UNIT(6 MCG)/0.5ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |