2022 Medicare Part D Plan Formulary Information |
BlueCross Total Value (PPO) (H8003-005-0)
Benefit Details
![Email Prescription and/or Health Benefit details for BlueCross Total Value (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) This plan covers select insulin pay $35 copay.
See individual insulin cost-sharing below. |
The BlueCross Total Value (PPO) (H8003-005-0) Formulary Drugs Starting with the Letter E in Dillon County, SC: CMS MA Region 8 which includes: SC
|
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ECONAZOLE NITRATE 1% CREAM (G) [Spectazole] ![Compare how all Medicare Part D PDP plans in SC cover ECONAZOLE NITRATE 1% CREAM (G) [Spectazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in SC cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | None |
EFAVIR-EMTRI-TENOF 600-200-300 TABLET [Atripla] ![Compare how all Medicare Part D PDP plans in SC cover EFAVIR-EMTRI-TENOF 600-200-300 TABLET [Atripla].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EFAVIR-LAMIV-TENOF 400-300-300 TABLET [SYMFI LO] ![Compare how all Medicare Part D PDP plans in SC cover EFAVIR-LAMIV-TENOF 400-300-300 TABLET [SYMFI LO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EFAVIR-LAMIV-TENOF 600-300-300 TABLET [SYMFI] ![Compare how all Medicare Part D PDP plans in SC cover EFAVIR-LAMIV-TENOF 600-300-300 TABLET [SYMFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EFAVIRENZ 200 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in SC cover EFAVIRENZ 200 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
EFAVIRENZ 50 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in SC cover EFAVIRENZ 50 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
EFAVIRENZ 600 MG TABLET [Sustiva] ![Compare how all Medicare Part D PDP plans in SC cover EFAVIRENZ 600 MG TABLET [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ELETRIPTAN HBR 20 MG TABLET [Relpax] ![Compare how all Medicare Part D PDP plans in SC cover ELETRIPTAN HBR 20 MG TABLET [Relpax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:12 /30Days |
ELETRIPTAN HBR 40 MG TABLET [Relpax] ![Compare how all Medicare Part D PDP plans in SC cover ELETRIPTAN HBR 40 MG TABLET [Relpax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:12 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIQUIS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ELIQUIS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:60 /30Days |
ELIQUIS 5 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in SC cover ELIQUIS 5 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:148 /365Days |
ELIQUIS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ELIQUIS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:90 /30Days |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in SC cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ELYXYB 120 MG/4.8 ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover ELYXYB 120 MG/4.8 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P Q:19 /30Days |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | None |
EMGALITY 120 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in SC cover EMGALITY 120 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P Q:1 /30Days |
EMGALITY 120 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover EMGALITY 120 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P Q:1 /30Days |
EMGALITY 300 MG (100 MG X3SYR) SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover EMGALITY 300 MG (100 MG X3SYR) SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:3 /30Days |
Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy] ![Compare how all Medicare Part D PDP plans in SC cover Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in SC cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in SC cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | S Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in SC cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | S Q:30 /30Days |
EMTRICITABINE 200 MG CAPSULE [Emtriva] ![Compare how all Medicare Part D PDP plans in SC cover EMTRICITABINE 200 MG CAPSULE [Emtriva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
EMTRICITABINE-TENOFV 100-150MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in SC cover EMTRICITABINE-TENOFV 100-150MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EMTRICITABINE-TENOFV 133-200MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in SC cover EMTRICITABINE-TENOFV 133-200MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EMTRICITABINE-TENOFV 167-250MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in SC cover EMTRICITABINE-TENOFV 167-250MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EMTRICITABINE-TENOFV 200-300MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in SC cover EMTRICITABINE-TENOFV 200-300MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ENALAPRIL MALEATE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL MALEATE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL MALEATE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL-HCTZ 10-25 MG TABLET [Vaseretic] ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL-HCTZ 10-25 MG TABLET [Vaseretic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL-HCTZ 5-12.5 MG TABLET [Vaseretic] ![Compare how all Medicare Part D PDP plans in SC cover ENALAPRIL-HCTZ 5-12.5 MG TABLET [Vaseretic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 25 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ENBREL 25 MG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 25 MG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ENBREL 50 MG/ML MINI CARTRIDGE ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 50 MG/ML MINI CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ENBREL 50 MG/ML SURECLICK PEN INJECTOR ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 50 MG/ML SURECLICK PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ENBREL 50 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ENBREL 50 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in SC cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | P |
ENGERIX-B 20 MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ENGERIX-B 20 MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | P |
ENOXAPARIN 100 MG/ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 100 MG/ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:35 /90Days |
ENOXAPARIN 120 MG/0.8 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 120 MG/0.8 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:28 /90Days |
ENOXAPARIN 150 MG/ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 150 MG/ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:35 /90Days |
ENOXAPARIN 30 MG/0.3 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 30 MG/0.3 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:11 /90Days |
ENOXAPARIN 40 MG/0.4 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 40 MG/0.4 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:14 /90Days |
ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:21 /90Days |
ENOXAPARIN 80 MG/0.8 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in SC cover ENOXAPARIN 80 MG/0.8 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:28 /90Days |
ENSPRYNG 120 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SC cover ENSPRYNG 120 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENTACAPONE 200 MG TABLET [Comtan] ![Compare how all Medicare Part D PDP plans in SC cover ENTACAPONE 200 MG TABLET [Comtan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ENTECAVIR 0.5 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in SC cover ENTECAVIR 0.5 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:30 /30Days |
ENTECAVIR 1 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in SC cover ENTECAVIR 1 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:30 /30Days |
ENTRESTO 24 MG-26 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENTRESTO 24 MG-26 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:60 /30Days |
ENTRESTO 49 MG-51 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENTRESTO 49 MG-51 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:60 /30Days |
ENTRESTO 97 MG-103 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ENTRESTO 97 MG-103 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:60 /30Days |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
EPIDIOLEX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover EPIDIOLEX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EPINASTINE HCL 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in SC cover EPINASTINE HCL 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPINEPHRINE 0.15 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in SC cover EPINEPHRINE 0.15 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPINEPHRINE 0.15 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in SC cover EPINEPHRINE 0.15 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPINEPHRINE 0.3 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in SC cover EPINEPHRINE 0.3 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in SC cover EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in SC cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
EPLERENONE 25 MG TABLET [Inspra] ![Compare how all Medicare Part D PDP plans in SC cover EPLERENONE 25 MG TABLET [Inspra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPLERENONE 50 MG TABLET [Inspra] ![Compare how all Medicare Part D PDP plans in SC cover EPLERENONE 50 MG TABLET [Inspra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
EPRONTIA 25 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover EPRONTIA 25 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ERGOLOID MESYLATES TABLETS 1MG 100 BOT ![Compare how all Medicare Part D PDP plans in SC cover ERGOLOID MESYLATES TABLETS 1MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Ergotamine-caffeine 1-100mg tablet ![Compare how all Medicare Part D PDP plans in SC cover Ergotamine-caffeine 1-100mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ERLEADA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ERLEADA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERLOTINIB HCL 100 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in SC cover ERLOTINIB HCL 100 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ERLOTINIB HCL 150 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in SC cover ERLOTINIB HCL 150 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ERLOTINIB HCL 25 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in SC cover ERLOTINIB HCL 25 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ERRIN 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in SC cover ERRIN 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ERTAPENEM 1 GRAM VIAL [Invanz] ![Compare how all Medicare Part D PDP plans in SC cover ERTAPENEM 1 GRAM VIAL [Invanz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in SC cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ERYTHROMYCIN 0.5% EYE OINTMENT [Romycin] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN 0.5% EYE OINTMENT [Romycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ERYTHROMYCIN 2% GEL [Erygel] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN 2% GEL [Erygel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ERYTHROMYCIN 2% SOLUTION ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ERYTHROMYCIN 200 MG/5 ML ORAL SUSPENSION [EryPed] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN 200 MG/5 ML ORAL SUSPENSION [EryPed].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ERYTHROMYCIN 400 MG/5 ML ORAL SUSPENSION [EryPed] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN 400 MG/5 ML ORAL SUSPENSION [EryPed].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN DR 250 MG TABLET [Ery-Tab] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN DR 250 MG TABLET [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ERYTHROMYCIN DR 333 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN DR 333 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ERYTHROMYCIN DR 500 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN DR 500 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ERYTHROMYCIN-BENZOYL GEL [Benzamycin] ![Compare how all Medicare Part D PDP plans in SC cover ERYTHROMYCIN-BENZOYL GEL [Benzamycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESBRIET 267 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover ESBRIET 267 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ESBRIET 267 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESBRIET 267 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ESBRIET 801 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESBRIET 801 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ESCITALOPRAM OXALATE 5 MG/5 ML SOLUTION [Lexapro] ![Compare how all Medicare Part D PDP plans in SC cover ESCITALOPRAM OXALATE 5 MG/5 ML SOLUTION [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESOMEPRAZOLE MAG DR 20 MG CAPSULE DR [Nexium 24HR Clear Minis] ![Compare how all Medicare Part D PDP plans in SC cover ESOMEPRAZOLE MAG DR 20 MG CAPSULE DR [Nexium 24HR Clear Minis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | Q:60 /30Days |
ESOMEPRAZOLE MAG DR 40 MG CAPSULE DR [Nexium] ![Compare how all Medicare Part D PDP plans in SC cover ESOMEPRAZOLE MAG DR 40 MG CAPSULE DR [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | Q:60 /30Days |
ESTARYLLA 0.25-0.035 MG TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in SC cover ESTARYLLA 0.25-0.035 MG TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C ![Compare how all Medicare Part D PDP plans in SC cover Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.01% CREAM ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
Estradiol 0.025 mg patch ![Compare how all Medicare Part D PDP plans in SC cover Estradiol 0.025 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.0375MG PATCH(1/WKClimara] ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.0375MG PATCH(1/WKClimara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.0375MG PATCH(2/WK) TDSW [Vivelle-Dot] ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.0375MG PATCH(2/WK) TDSW [Vivelle-Dot].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Estradiol 0.05 mg patch ![Compare how all Medicare Part D PDP plans in SC cover Estradiol 0.05 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.05 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.05 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.06 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.06 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Estradiol 0.075 mg patch ![Compare how all Medicare Part D PDP plans in SC cover Estradiol 0.075 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.075 MG PATCH(1/WKClimara] ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.075 MG PATCH(1/WKClimara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Estradiol 0.1 mg patch ![Compare how all Medicare Part D PDP plans in SC cover Estradiol 0.1 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.1 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.1 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ESTRADIOL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ESTRADIOL 10 MCG VAGINAL INSRT ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 10 MCG VAGINAL INSRT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ESTRADIOL TDS 0.025 MG/DAY ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL TDS 0.025 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in SC cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:1 /90Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESZOPICLONE 1 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in SC cover ESZOPICLONE 1 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:30 /30Days |
ESZOPICLONE 2 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in SC cover ESZOPICLONE 2 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:30 /30Days |
ESZOPICLONE 3 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in SC cover ESZOPICLONE 3 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:30 /30Days |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in SC cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6 ![Compare how all Medicare Part D PDP plans in SC cover ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TABLET 21 ![Compare how all Medicare Part D PDP plans in SC cover ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TABLET 21.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETHOSUXIMIDE 250 MG CAPSULE [Zarontin] ![Compare how all Medicare Part D PDP plans in SC cover ETHOSUXIMIDE 250 MG CAPSULE [Zarontin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETHOSUXIMIDE 250 MG/5 ML SOLUTION [Zarontin] ![Compare how all Medicare Part D PDP plans in SC cover ETHOSUXIMIDE 250 MG/5 ML SOLUTION [Zarontin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in SC cover ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETHYNODIOL-ETH ESTRA 1MG-50MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in SC cover ETHYNODIOL-ETH ESTRA 1MG-50MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETODOLAC 200 MG CAPSULE [Lodine] ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 200 MG CAPSULE [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETODOLAC 300 MG CAPSULE [Lodine] ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 300 MG CAPSULE [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETODOLAC 400 MG TABLET [Lodine] ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 400 MG TABLET [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETODOLAC 500 MG TABLET [Lodine] ![Compare how all Medicare Part D PDP plans in SC cover ETODOLAC 500 MG TABLET [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $100.00 | None |
ETRAVIRINE 100 MG TABLET [INTELENCE] ![Compare how all Medicare Part D PDP plans in SC cover ETRAVIRINE 100 MG TABLET [INTELENCE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
ETRAVIRINE 200 MG TABLET [INTELENCE] ![Compare how all Medicare Part D PDP plans in SC cover ETRAVIRINE 200 MG TABLET [INTELENCE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | None |
EUCRISA 2% OINTMENT ![Compare how all Medicare Part D PDP plans in SC cover EUCRISA 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
EVEROLIMUS 0.25 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 0.25 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
EVEROLIMUS 0.5 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 0.5 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EVEROLIMUS 0.75 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 0.75 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EVEROLIMUS 1 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 1 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EVEROLIMUS 10 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 10 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:30 /30Days |
EVEROLIMUS 2 MG TABLET FOR SUSP [Afinitor DISPERZ] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 2 MG TABLET FOR SUSP [Afinitor DISPERZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EVEROLIMUS 2.5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 2.5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:30 /30Days |
EVEROLIMUS 3 MG TABLET FOR SUSP [Afinitor DISPERZ] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 3 MG TABLET FOR SUSP [Afinitor DISPERZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EVEROLIMUS 5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:30 /30Days |
EVEROLIMUS 5 MG TABLET FOR SUSP [Afinitor DISPERZ] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 5 MG TABLET FOR SUSP [Afinitor DISPERZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EVEROLIMUS 7.5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in SC cover EVEROLIMUS 7.5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:30 /30Days |
EVOTAZ 300 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in SC cover EVOTAZ 300 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | Q:30 /30Days |
EVRYSDI 60 MG/80 ML(0.75MG/ML) SOLUTION RECON ![Compare how all Medicare Part D PDP plans in SC cover EVRYSDI 60 MG/80 ML(0.75MG/ML) SOLUTION RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:240 /30Days |
EXEMESTANE 25 MG TABLET [Aromasin] ![Compare how all Medicare Part D PDP plans in SC cover EXEMESTANE 25 MG TABLET [Aromasin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
EXKIVITY 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SC cover EXKIVITY 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EXSERVAN 50 MG FILM ![Compare how all Medicare Part D PDP plans in SC cover EXSERVAN 50 MG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P |
EXTAVIA 0.3 MG KIT ![Compare how all Medicare Part D PDP plans in SC cover EXTAVIA 0.3 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
31% | 31% | P Q:15 /30Days |
EZETIMIBE 10 MG TABLET [Zetia] ![Compare how all Medicare Part D PDP plans in SC cover EZETIMIBE 10 MG TABLET [Zetia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
EZETIMIBE-SIMVASTATIN 10-10 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in SC cover EZETIMIBE-SIMVASTATIN 10-10 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
EZETIMIBE-SIMVASTATIN 10-20 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in SC cover EZETIMIBE-SIMVASTATIN 10-20 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
EZETIMIBE-SIMVASTATIN 10-40 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in SC cover EZETIMIBE-SIMVASTATIN 10-40 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |
EZETIMIBE-SIMVASTATIN 10-80 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in SC cover EZETIMIBE-SIMVASTATIN 10-80 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $37.50 | None |