2023 Medicare Part D Plan Formulary Information |
Health Alliance Medicare HMO Basic Rx (HMO) (H1463-009-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO Basic Rx (HMO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Call drug plan for more details. |
The Health Alliance Medicare HMO Basic Rx (HMO) (H1463-009-0) Formulary Drugs Starting with the Letter B in Jasper County, IL: CMS MA Region 14 which includes: IL
|
Drugs Starting with Letter B
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Bacitracin 500 unit/gm Eye Ointment ![Compare how all Medicare Part D PDP plans in IL cover Bacitracin 500 unit/gm Eye Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT ![Compare how all Medicare Part D PDP plans in IL cover BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BACLOFEN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BACLOFEN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BACLOFEN 20 MG TABLET [Lioresal] ![Compare how all Medicare Part D PDP plans in IL cover BACLOFEN 20 MG TABLET [Lioresal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BACLOFEN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BACLOFEN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BAFIERTAM DR 95 MG CAPSULE DR ![Compare how all Medicare Part D PDP plans in IL cover BAFIERTAM DR 95 MG CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:120 /30Days |
BALSALAZIDE DISODIUM 750 MG CAPSULE [Colazal] ![Compare how all Medicare Part D PDP plans in IL cover BALSALAZIDE DISODIUM 750 MG CAPSULE [Colazal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BALVERSA 3 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BALVERSA 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BALVERSA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BALVERSA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BALVERSA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BALVERSA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BAXDELA 300 MG VIAL ![Compare how all Medicare Part D PDP plans in IL cover BAXDELA 300 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BAXDELA 450 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BAXDELA 450 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BCG VACCINE 50mg/1 1 VIAL per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in IL cover BCG VACCINE 50mg/1 1 VIAL per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
BELBUCA 150 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 150 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
BELBUCA 300 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 300 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
BELBUCA 450 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 450 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
BELBUCA 600 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 600 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
BELBUCA 75 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 75 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
BELBUCA 750 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 750 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
BELBUCA 900 MCG FILM ![Compare how all Medicare Part D PDP plans in IL cover BELBUCA 900 MCG FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BELSOMRA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BELSOMRA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BELSOMRA 15 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BELSOMRA 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BELSOMRA 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BELSOMRA 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BELSOMRA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BELSOMRA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BENAZEPRIL HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENAZEPRIL HCL 20 MG TABLET [Lotensin] ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL HCL 20 MG TABLET [Lotensin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENAZEPRIL HCL 40 MG TABLET [Lotensin] ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL HCL 40 MG TABLET [Lotensin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENAZEPRIL HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENAZEPRIL-HCTZ 10-12.5 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL-HCTZ 10-12.5 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENAZEPRIL-HCTZ 20-12.5 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL-HCTZ 20-12.5 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENAZEPRIL-HCTZ 20-25 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL-HCTZ 20-25 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENAZEPRIL-HCTZ 5-6.25 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in IL cover BENAZEPRIL-HCTZ 5-6.25 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENLYSTA 200 MG/ML AUTOINJECT ![Compare how all Medicare Part D PDP plans in IL cover BENLYSTA 200 MG/ML AUTOINJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BENLYSTA 200 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IL cover BENLYSTA 200 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BENZTROPINE MES 0.5 MG TABLET [Cogentin] ![Compare how all Medicare Part D PDP plans in IL cover BENZTROPINE MES 0.5 MG TABLET [Cogentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENZTROPINE MES 1 MG TABLET [Cogentin] ![Compare how all Medicare Part D PDP plans in IL cover BENZTROPINE MES 1 MG TABLET [Cogentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BENZTROPINE MES 2 MG TABLET [Cogentin] ![Compare how all Medicare Part D PDP plans in IL cover BENZTROPINE MES 2 MG TABLET [Cogentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BERINERT 500 UNIT KIT ![Compare how all Medicare Part D PDP plans in IL cover BERINERT 500 UNIT KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BESREMI 500 MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IL cover BESREMI 500 MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BETAINE 1 GRAM/SCOOP POWDER [Cystadane] ![Compare how all Medicare Part D PDP plans in IL cover BETAINE 1 GRAM/SCOOP POWDER [Cystadane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
Betamethasone Dipropionate 0.64mg/g / 45 g TUBE ![Compare how all Medicare Part D PDP plans in IL cover Betamethasone Dipropionate 0.64mg/g / 45 g TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE DP 0.05% LOTION ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE DP 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAMETHASONE DP 0.05% OINTMENT [Maxivate] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE DP 0.05% OINTMENT [Maxivate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE DP AUG 0.05% CREAM (g) [RRB Pak] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE DP AUG 0.05% CREAM (g) [RRB Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE DP AUG 0.05% GEL ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE DP AUG 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE DP AUG 0.05% LOTION [Diprolene] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE DP AUG 0.05% LOTION [Diprolene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE DP AUG 0.05% OINTMENT [Diprolene] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE DP AUG 0.05% OINTMENT [Diprolene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE VA 0.1% CREAM (G) [Valisone] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE VA 0.1% CREAM (G) [Valisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE VALER 0.1% LOTION [Valisone] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE VALER 0.1% LOTION [Valisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETAMETHASONE VALER 0.1% OINTMENT [Valisone] ![Compare how all Medicare Part D PDP plans in IL cover BETAMETHASONE VALER 0.1% OINTMENT [Valisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETASERON 0.3 MG KIT ![Compare how all Medicare Part D PDP plans in IL cover BETASERON 0.3 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BETAXOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BETAXOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BETAXOLOL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BETAXOLOL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAXOLOL HCL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in IL cover BETAXOLOL HCL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BETHANECHOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BETHANECHOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETHANECHOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BETHANECHOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETHANECHOL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BETHANECHOL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BETHANECHOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BETHANECHOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BEVESPI AEROSPHERE INHALER ![Compare how all Medicare Part D PDP plans in IL cover BEVESPI AEROSPHERE INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
BEXAROTENE 1% GEL [Targretin] ![Compare how all Medicare Part D PDP plans in IL cover BEXAROTENE 1% GEL [Targretin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BEXAROTENE 75 MG CAPSULE [Targretin] ![Compare how all Medicare Part D PDP plans in IL cover BEXAROTENE 75 MG CAPSULE [Targretin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BEXSERO PREFILLED SYRINGE ![Compare how all Medicare Part D PDP plans in IL cover BEXSERO PREFILLED SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BICALUTAMIDE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BICALUTAMIDE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BICILL LA PFS 600MU 1ML PED ![Compare how all Medicare Part D PDP plans in IL cover BICILL LA PFS 600MU 1ML PED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BICILLIN C-R 1.2MM UNITS SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in IL cover BICILLIN C-R 1.2MM UNITS SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BICILLIN C-R 900/300 SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in IL cover BICILLIN C-R 900/300 SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BICILLIN LA PFS 1200MU 2ML ![Compare how all Medicare Part D PDP plans in IL cover BICILLIN LA PFS 1200MU 2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BICILLIN LA. 600000UNIT/ML 1ML ![Compare how all Medicare Part D PDP plans in IL cover BICILLIN LA. 600000UNIT/ML 1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BIDIL 20 MG-37.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BIDIL 20 MG-37.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
BIKTARVY 30-120-15 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BIKTARVY 30-120-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BIKTARVY 50-200-25 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BIKTARVY 50-200-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BISOPROLOL FUMARATE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BISOPROLOL FUMARATE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BISOPROLOL FUMARATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BISOPROLOL FUMARATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BISOPROLOL-HCTZ 10-6.25 MG TABLET [Ziac] ![Compare how all Medicare Part D PDP plans in IL cover BISOPROLOL-HCTZ 10-6.25 MG TABLET [Ziac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BISOPROLOL-HCTZ 2.5-6.25 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BISOPROLOL-HCTZ 2.5-6.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BISOPROLOL-HCTZ 5-6.25 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BISOPROLOL-HCTZ 5-6.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BIVIGAM 10% VIAL [Panzyga] ![Compare how all Medicare Part D PDP plans in IL cover BIVIGAM 10% VIAL [Panzyga].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BLISOVI 24 FE TABLET [Tarina Fe 1/20] ![Compare how all Medicare Part D PDP plans in IL cover BLISOVI 24 FE TABLET [Tarina Fe 1/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BOOSTRIX TDAP VACCINE SYRINGE ![Compare how all Medicare Part D PDP plans in IL cover BOOSTRIX TDAP VACCINE SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BOOSTRIX TDAP VACCINE VIAL ![Compare how all Medicare Part D PDP plans in IL cover BOOSTRIX TDAP VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BOSULIF 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BOSULIF 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BOSULIF 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BOSULIF 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BOSULIF 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BOSULIF 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BRAFTOVI 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover BRAFTOVI 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BREZTRI AEROSPHERE INHALER HFA AER AD ![Compare how all Medicare Part D PDP plans in IL cover BREZTRI AEROSPHERE INHALER HFA AER AD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BRILINTA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BRILINTA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BRILINTA 90mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IL cover BRILINTA 90mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BRIMONIDINE 0.2% EYE DROPS [Alphagan] ![Compare how all Medicare Part D PDP plans in IL cover BRIMONIDINE 0.2% EYE DROPS [Alphagan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BRIMONIDINE TARTRATE 0.15% DROPS [Alphagan P] ![Compare how all Medicare Part D PDP plans in IL cover BRIMONIDINE TARTRATE 0.15% DROPS [Alphagan P].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BRIMONIDINE-TIMOLOL 0.2%-0.5% DROPS [Combigan] ![Compare how all Medicare Part D PDP plans in IL cover BRIMONIDINE-TIMOLOL 0.2%-0.5% DROPS [Combigan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BRINZOLAMIDE 1% EYE DROPS/EYE DROPPER [Azopt] ![Compare how all Medicare Part D PDP plans in IL cover BRINZOLAMIDE 1% EYE DROPS/EYE DROPPER [Azopt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BRIVIACT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BRIVIACT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | S |
BRIVIACT 10 MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IL cover BRIVIACT 10 MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | S |
BRIVIACT 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BRIVIACT 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | S |
BRIVIACT 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BRIVIACT 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | S |
BRIVIACT 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BRIVIACT 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | S |
BRIVIACT 75 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BRIVIACT 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom] ![Compare how all Medicare Part D PDP plans in IL cover BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BROMOCRIPTINE 2.5 MG TABLET [Parlodel] ![Compare how all Medicare Part D PDP plans in IL cover BROMOCRIPTINE 2.5 MG TABLET [Parlodel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BROMOCRIPTINE 5 MG CAPSULE [Parlodel] ![Compare how all Medicare Part D PDP plans in IL cover BROMOCRIPTINE 5 MG CAPSULE [Parlodel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BROMSITE 0.075% EYE DROPS ![Compare how all Medicare Part D PDP plans in IL cover BROMSITE 0.075% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
BROVANA 15MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in IL cover BROVANA 15MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | P |
BRUKINSA 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover BRUKINSA 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
BUDESONIDE 0.25 MG/2 ML SUSP AMPUL-NEB [Pulmicort] ![Compare how all Medicare Part D PDP plans in IL cover BUDESONIDE 0.25 MG/2 ML SUSP AMPUL-NEB [Pulmicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
BUDESONIDE 0.5 MG/2 ML SUSP AMPUL-NEB [Pulmicort] ![Compare how all Medicare Part D PDP plans in IL cover BUDESONIDE 0.5 MG/2 ML SUSP AMPUL-NEB [Pulmicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
BUDESONIDE 1 MG/2 ML INH SUSP AMPUL-NEB [Pulmicort] ![Compare how all Medicare Part D PDP plans in IL cover BUDESONIDE 1 MG/2 ML INH SUSP AMPUL-NEB [Pulmicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
BUDESONIDE 2 MG RECTAL FOAM/APPL [UCERIS Rectal] ![Compare how all Medicare Part D PDP plans in IL cover BUDESONIDE 2 MG RECTAL FOAM/APPL [UCERIS Rectal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | None |
BUDESONIDE EC 3 MG CAPSULE DR - ER [Entocort EC] ![Compare how all Medicare Part D PDP plans in IL cover BUDESONIDE EC 3 MG CAPSULE DR - ER [Entocort EC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUDESONIDE ER 9 MG TABLET ER [UCERIS] ![Compare how all Medicare Part D PDP plans in IL cover BUDESONIDE ER 9 MG TABLET ER [UCERIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
BUMETANIDE 0.5 MG TABLET [Bumex] ![Compare how all Medicare Part D PDP plans in IL cover BUMETANIDE 0.5 MG TABLET [Bumex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUMETANIDE 1 MG TABLET [Bumex] ![Compare how all Medicare Part D PDP plans in IL cover BUMETANIDE 1 MG TABLET [Bumex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUMETANIDE 1 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in IL cover BUMETANIDE 1 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUMETANIDE 2 MG TABLET [Bumex] ![Compare how all Medicare Part D PDP plans in IL cover BUMETANIDE 2 MG TABLET [Bumex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPRENORP-NALOX 12-3 MG SL FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORP-NALOX 12-3 MG SL FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHIN-NALOXON 8-2 MG SL SUSLIGUAL TABLET [Suboxone] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHIN-NALOXON 8-2 MG SL SUSLIGUAL TABLET [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHINE 10 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 10 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPRENORPHINE 15 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 15 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPRENORPHINE 2 MG SUBLIGUAL TABLET [Subutex] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 2 MG SUBLIGUAL TABLET [Subutex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHINE 20 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 20 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPRENORPHINE 5 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 5 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPRENORPHINE 7.5 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 7.5 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPRENORPHINE 8 MG TABLET SUSLIGUAL [Subutex] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE 8 MG TABLET SUSLIGUAL [Subutex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHINE-NALOX 2-0.5MG FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE-NALOX 2-0.5MG FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHINE-NALOX 4-1MG FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE-NALOX 4-1MG FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHINE-NALOX 8-2MG FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHINE-NALOX 8-2MG FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPRENORPHN-NALOXN 2-0.5 MG TABLET SUSLIGUAL [Suboxone] ![Compare how all Medicare Part D PDP plans in IL cover BUPRENORPHN-NALOXN 2-0.5 MG TABLET SUSLIGUAL [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:90 /30Days |
BUPROPION HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BUPROPION HCL 75 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BUPROPION HCL SR 100 MG TABLET SR 12H [Wellbutrin SR] ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL SR 100 MG TABLET SR 12H [Wellbutrin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BUPROPION HCL SR 150 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL SR 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPROPION HCL SR 150 MG TABLET SR 12H [Wellbutrin SR] ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL SR 150 MG TABLET SR 12H [Wellbutrin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BUPROPION HCL SR 200 MG TABLET SR 12H [Wellbutrin SR] ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL SR 200 MG TABLET SR 12H [Wellbutrin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
BUPROPION HCL XL 150 MG TABLET ER 24H [Wellbutrin XL] ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL XL 150 MG TABLET ER 24H [Wellbutrin XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPROPION HCL XL 300 MG TABLET ER 24H [Wellbutrin XL] ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL XL 300 MG TABLET ER 24H [Wellbutrin XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUPROPION HCL XL 450 MG TABLET ER 24H [Forfivo XL] ![Compare how all Medicare Part D PDP plans in IL cover BUPROPION HCL XL 450 MG TABLET ER 24H [Forfivo XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
BUSPIRONE HCL 15 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUSPIRONE HCL 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUSPIRONE HCL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUSPIRONE HCL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUSPIRONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUSPIRONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUSPIRONE HCL 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUSPIRONE HCL 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUSPIRONE HYDROCHLORIDE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IL cover BUSPIRONE HYDROCHLORIDE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUTALB-ACETAMIN-CAFF 50-300-40 CAPSULE [Phrenilin Forte] ![Compare how all Medicare Part D PDP plans in IL cover BUTALB-ACETAMIN-CAFF 50-300-40 CAPSULE [Phrenilin Forte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUTALB-ACETAMIN-CAFF 50-325-40 TABLET [Repan] ![Compare how all Medicare Part D PDP plans in IL cover BUTALB-ACETAMIN-CAFF 50-325-40 TABLET [Repan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUTALB-CAFF-ACETAMINOPH-CODEIN ![Compare how all Medicare Part D PDP plans in IL cover BUTALB-CAFF-ACETAMINOPH-CODEIN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUTALBITAL-ASA-CAFFEINE CAPSULE [Fiorinal] ![Compare how all Medicare Part D PDP plans in IL cover BUTALBITAL-ASA-CAFFEINE CAPSULE [Fiorinal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUTALBITAL/ACETAMINOPHEN/CAFFEINE CAPSULE ![Compare how all Medicare Part D PDP plans in IL cover BUTALBITAL/ACETAMINOPHEN/CAFFEINE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
BUTORPHANOL 10 MG/ML SPRAY [Stadol NS] ![Compare how all Medicare Part D PDP plans in IL cover BUTORPHANOL 10 MG/ML SPRAY [Stadol NS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:5 /28Days |
BYDUREON BCISE 2 MG AUTOINJECT ![Compare how all Medicare Part D PDP plans in IL cover BYDUREON BCISE 2 MG AUTOINJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |