2023 Medicare Part D Plan Formulary Information |
Medicare Blue Choice Extra (HMO) (H3351-021-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Medicare Blue Choice Extra (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 Medicare Blue Choice Extra (HMO) (H3351-021-0) Formulary Drugs Starting with the Letter I in Yates County, NY: CMS MA Region 3 which includes: NY
|
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 NY cover IBANDRONATE SODIUM 150 MG TABLET [Boniva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IBRANCE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover IBRANCE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:21 /28Days |
IBRANCE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IBRANCE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:21 /28Days |
IBRANCE 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover IBRANCE 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:21 /28Days |
IBRANCE 125 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IBRANCE 125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:21 /28Days |
IBRANCE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover IBRANCE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:21 /28Days |
IBRANCE 75 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IBRANCE 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:21 /28Days |
IBU 600 MG TABLET [Toxicology Saliva Collection] ![Compare how all Medicare Part D PDP plans in NY cover IBU 600 MG TABLET [Toxicology Saliva Collection].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IBU 800 MG TABLET [Samson-8] ![Compare how all Medicare Part D PDP plans in NY cover IBU 800 MG TABLET [Samson-8].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [PediaCare Children's Pain Reliever/Fever Reducer IB] ![Compare how all Medicare Part D PDP plans in NY 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 |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IBUPROFEN 400 MG TABLET [Motrin] ![Compare how all Medicare Part D PDP plans in NY cover IBUPROFEN 400 MG TABLET [Motrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IBUPROFEN 600 MG TABLET [Toxicology Saliva Collection] ![Compare how all Medicare Part D PDP plans in NY cover IBUPROFEN 600 MG TABLET [Toxicology Saliva Collection].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IBUPROFEN 800 MG TABLET [Samson-8] ![Compare how all Medicare Part D PDP plans in NY cover IBUPROFEN 800 MG TABLET [Samson-8].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ICATIBANT 30 MG/3 ML SYRINGE [FIRAZYR] ![Compare how all Medicare Part D PDP plans in NY cover ICATIBANT 30 MG/3 ML SYRINGE [FIRAZYR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
ICLEVIA 0.15 MG-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in NY 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 |
$15.00 | $30.00 | None |
ICLUSIG 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ICLUSIG 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
ICLUSIG 15 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ICLUSIG 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
ICLUSIG 30 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ICLUSIG 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
ICLUSIG 45 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ICLUSIG 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
ICOSAPENT ETHYL 1 GRAM CAPSULE [VASCEPA] ![Compare how all Medicare Part D PDP plans in NY cover ICOSAPENT ETHYL 1 GRAM CAPSULE [VASCEPA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:120 /30Days |
ICOSAPENT ETHYL 500 MG CAPSULE [VASCEPA] ![Compare how all Medicare Part D PDP plans in NY cover ICOSAPENT ETHYL 500 MG CAPSULE [VASCEPA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IDHIFA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IDHIFA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
IDHIFA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IDHIFA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
ILUMYA 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover ILUMYA 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:3 /28Days |
IMATINIB MESYLATE 100 MG TABLET [Gleevec] ![Compare how all Medicare Part D PDP plans in NY cover IMATINIB MESYLATE 100 MG TABLET [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:120 /30Days |
IMATINIB MESYLATE 400 MG TABLET [Gleevec] ![Compare how all Medicare Part D PDP plans in NY cover IMATINIB MESYLATE 400 MG TABLET [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:60 /30Days |
IMBRUVICA 140 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover IMBRUVICA 140 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:120 /30Days |
IMBRUVICA 420 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IMBRUVICA 420 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
IMBRUVICA 70 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover IMBRUVICA 70 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
IMBRUVICA 70 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover IMBRUVICA 70 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:216 /27Days |
IMIPRAMINE HCL 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE HCL 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
IMIPRAMINE HCL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE HCL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMIPRAMINE HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
IMIPRAMINE PAMOATE 100 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE PAMOATE 100 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IMIPRAMINE PAMOATE 125 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE PAMOATE 125 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IMIPRAMINE PAMOATE 150 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE PAMOATE 150 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IMIPRAMINE PAMOATE 75 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in NY cover IMIPRAMINE PAMOATE 75 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IMIQUIMOD 5% CREAM PACKET ![Compare how all Medicare Part D PDP plans in NY cover IMIQUIMOD 5% CREAM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IMOVAX RABIES VACCINE VIAL ![Compare how all Medicare Part D PDP plans in NY cover IMOVAX RABIES VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | P |
INBRIJA 42 MG INHALATION CAPSULE W/DEV ![Compare how all Medicare Part D PDP plans in NY cover INBRIJA 42 MG INHALATION CAPSULE W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
INCASSIA 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in NY cover INCASSIA 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | 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 NY 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 |
26% | 26% | P |
INCRUSE ELLIPTA 62.5 MCG INH ![Compare how all Medicare Part D PDP plans in NY cover INCRUSE ELLIPTA 62.5 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INDAPAMIDE 1.25 MG TABLET [Lozol] ![Compare how all Medicare Part D PDP plans in NY cover INDAPAMIDE 1.25 MG TABLET [Lozol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
INDAPAMIDE 2.5 MG TABLET [Lozol] ![Compare how all Medicare Part D PDP plans in NY cover INDAPAMIDE 2.5 MG TABLET [Lozol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | None |
INDOMETHACIN 25 MG CAPSULE [Indocin] ![Compare how all Medicare Part D PDP plans in NY cover INDOMETHACIN 25 MG CAPSULE [Indocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
INDOMETHACIN 50 MG CAPSULE [Indocin] ![Compare how all Medicare Part D PDP plans in NY cover INDOMETHACIN 50 MG CAPSULE [Indocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
INDOMETHACIN ER 75 MG CAPSULE ER [Indocin SR] ![Compare how all Medicare Part D PDP plans in NY cover INDOMETHACIN ER 75 MG CAPSULE ER [Indocin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
INFANRIX DTAP SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover INFANRIX DTAP SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
INGREZZA 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover INGREZZA 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:30 /30Days |
INGREZZA 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover INGREZZA 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
INGREZZA 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover INGREZZA 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
INGREZZA INITIATION PACK CAPSULE DS PK ![Compare how all Medicare Part D PDP plans in NY cover INGREZZA INITIATION PACK CAPSULE DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
INLYTA 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INLYTA 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INLYTA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INLYTA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:120 /30Days |
INQOVI 35 MG-100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INQOVI 35 MG-100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
INREBIC 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover INREBIC 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P |
INSULIN GLARGINE 100 UNIT/ML VIAL [Semglee] ![Compare how all Medicare Part D PDP plans in NY cover INSULIN GLARGINE 100 UNIT/ML VIAL [Semglee].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35 max* | $84.00 | None |
INSULIN GLARGINE SOLOSTAR U100 INSULN PEN [Semglee] ![Compare how all Medicare Part D PDP plans in NY cover INSULIN GLARGINE SOLOSTAR U100 INSULN PEN [Semglee].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35 max* | $84.00 | None |
INSULIN LISPRO 100 UNIT/ML INSULN PEN [LYUMJEV] ![Compare how all Medicare Part D PDP plans in NY cover INSULIN LISPRO 100 UNIT/ML INSULN PEN [LYUMJEV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35 max* | $84.00 | None |
INSULIN LISPRO 100 UNIT/ML VIAL [LYUMJEV] ![Compare how all Medicare Part D PDP plans in NY cover INSULIN LISPRO 100 UNIT/ML VIAL [LYUMJEV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35 max* | $84.00 | P |
INSULIN LISPRO JR 100 UNIT/ML INSULN PEN HF ![Compare how all Medicare Part D PDP plans in NY cover INSULIN LISPRO JR 100 UNIT/ML INSULN PEN HF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$35 max* | $84.00 | None |
INSULIN LISPRO MIX 75-25 KWIKPEN INSULN PEN [Humalog KwikPen Mix 75/25] ![Compare how all Medicare Part D PDP plans in NY 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) |
3 |
Preferred Brand |
$35 max* | $84.00 | None |
INTELENCE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INTELENCE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | Q:120 /30Days |
INTRALIPID 20% IV FAT EMULSION ![Compare how all Medicare Part D PDP plans in NY cover INTRALIPID 20% IV FAT EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INTRALIPID 30% IV FAT EMULSION ![Compare how all Medicare Part D PDP plans in NY cover INTRALIPID 30% IV FAT EMULSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | P |
INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in NY cover INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
INVEGA HAFYERA 1,092 MG/3.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover INVEGA HAFYERA 1,092 MG/3.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
INVEGA HAFYERA 1,560 MG/5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover INVEGA HAFYERA 1,560 MG/5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
Invega Sustenna 117 mg/0.75mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in NY cover Invega Sustenna 117 mg/0.75mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
Invega Sustenna 156 mg/mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in NY cover Invega Sustenna 156 mg/mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
Invega Sustenna 234 mg/1.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in NY cover Invega Sustenna 234 mg/1.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
Invega Sustenna 39 mg/0.25mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in NY cover Invega Sustenna 39 mg/0.25mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
Invega Sustenna 78 mg/0.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in NY cover Invega Sustenna 78 mg/0.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
INVEGA TRINZA 273 MG/0.875 ML ![Compare how all Medicare Part D PDP plans in NY cover INVEGA TRINZA 273 MG/0.875 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
INVEGA TRINZA 410 MG/1.315 ML ![Compare how all Medicare Part D PDP plans in NY cover INVEGA TRINZA 410 MG/1.315 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVEGA TRINZA 546 MG/1.75 ML ![Compare how all Medicare Part D PDP plans in NY cover INVEGA TRINZA 546 MG/1.75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
INVEGA TRINZA 819 MG/2.625 ML ![Compare how all Medicare Part D PDP plans in NY cover INVEGA TRINZA 819 MG/2.625 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
INVOKAMET 150-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET 150-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
INVOKAMET 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
INVOKAMET 50-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET 50-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
INVOKAMET 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
INVOKAMET XR 150-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET XR 150-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
INVOKAMET XR 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET XR 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
INVOKAMET XR 50-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET XR 50-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
INVOKAMET XR 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKAMET XR 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
INVOKANA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKANA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVOKANA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover INVOKANA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
IOPIDINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NY cover IOPIDINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IPOL VIAL 40;8;32; UNT ![Compare how all Medicare Part D PDP plans in NY cover IPOL VIAL 40;8;32; UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IPRAT-ALBUT 0.5-3(2.5) MG/3 ML AMPUL-NEB [DuoNeb] ![Compare how all Medicare Part D PDP plans in NY cover IPRAT-ALBUT 0.5-3(2.5) MG/3 ML AMPUL-NEB [DuoNeb].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | P |
IPRATROPIUM 0.06% SPRAY ![Compare how all Medicare Part D PDP plans in NY cover IPRATROPIUM 0.06% SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IPRATROPIUM BR 0.02% SOLUTION [Atrovent] ![Compare how all Medicare Part D PDP plans in NY cover IPRATROPIUM BR 0.02% SOLUTION [Atrovent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | P |
IPRATROPIUM BROMIDE NASAL SPRAY ![Compare how all Medicare Part D PDP plans in NY cover IPRATROPIUM BROMIDE NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
IRBESARTAN 150 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in NY cover IRBESARTAN 150 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
IRBESARTAN 300 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in NY cover IRBESARTAN 300 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
IRBESARTAN 75 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in NY cover IRBESARTAN 75 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in NY cover IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in NY cover IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
IRESSA 250 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover IRESSA 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | Q:30 /30Days |
ISENTRESS 100 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in NY cover ISENTRESS 100 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
ISENTRESS 100 MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in NY cover ISENTRESS 100 MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | Q:60 /30Days |
ISENTRESS 25 MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in NY cover ISENTRESS 25 MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ISENTRESS 400MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISENTRESS 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | Q:60 /30Days |
ISENTRESS HD 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISENTRESS HD 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | Q:60 /30Days |
ISIBLOOM 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in NY cover ISIBLOOM 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOLYTE P IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in NY cover ISOLYTE P IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
ISOLYTE S IV SOLUTION PH7.4 ![Compare how all Medicare Part D PDP plans in NY cover ISOLYTE S IV SOLUTION PH7.4.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
ISONIAZID 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISONIAZID 100 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 |
ISONIAZID 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISONIAZID 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISONIAZID 50MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in NY cover ISONIAZID 50MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE DINITRATE 10 MG TABLET [Wesorbide] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE DINITRATE 10 MG TABLET [Wesorbide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE DINITRATE 20 MG TABLET [Wesorbide] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE DINITRATE 20 MG TABLET [Wesorbide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE DINITRATE 40 MG TABLET [Sorbitrate] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE DINITRATE 40 MG TABLET [Sorbitrate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
ISOSORBIDE DN 30 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE DN 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE DN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE DN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE MN ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE MN ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE MONONIT 10 MG TABLET [Monoket] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE MONONIT 10 MG TABLET [Monoket].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE MONONIT 20 MG TABLET [Monoket] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE MONONIT 20 MG TABLET [Monoket].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE MONONIT ER 120 MG TABLET 24H [Imdur] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE MONONIT ER 120 MG TABLET 24H [Imdur].](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 |
ISOSORBIDE MONONIT ER 60 MG TABLET 24H [Isotrate ER] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE MONONIT ER 60 MG TABLET 24H [Isotrate ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOSORBIDE-HYDRALAZINE 20-37.5 TABLET [BiDil] ![Compare how all Medicare Part D PDP plans in NY cover ISOSORBIDE-HYDRALAZINE 20-37.5 TABLET [BiDil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | Q:180 /30Days |
ISOTON GENTAMICIN 80MG/100ML ![Compare how all Medicare Part D PDP plans in NY cover ISOTON GENTAMICIN 80MG/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOTONIC GENTAMICIN 100 MG/100 ML ![Compare how all Medicare Part D PDP plans in NY cover ISOTONIC GENTAMICIN 100 MG/100 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOTONIC GENTAMICIN 80 MG/50 ML ![Compare how all Medicare Part D PDP plans in NY cover ISOTONIC GENTAMICIN 80 MG/50 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISOTRETINOIN 10 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in NY cover ISOTRETINOIN 10 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ISOTRETINOIN 20 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in NY cover ISOTRETINOIN 20 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ISOTRETINOIN 25 MG CAPSULE [Absorica] ![Compare how all Medicare Part D PDP plans in NY cover ISOTRETINOIN 25 MG CAPSULE [Absorica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
ISOTRETINOIN 30 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in NY cover ISOTRETINOIN 30 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
ISOTRETINOIN 35 MG CAPSULE [Absorica] ![Compare how all Medicare Part D PDP plans in NY cover ISOTRETINOIN 35 MG CAPSULE [Absorica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | None |
ISOTRETINOIN 40 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in NY cover ISOTRETINOIN 40 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISRADIPINE 2.5 MG CAPSULE [DynaCirc] ![Compare how all Medicare Part D PDP plans in NY cover ISRADIPINE 2.5 MG CAPSULE [DynaCirc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISRADIPINE 5 MG CAPSULE [DynaCirc] ![Compare how all Medicare Part D PDP plans in NY cover ISRADIPINE 5 MG CAPSULE [DynaCirc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
ISTURISA 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISTURISA 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:240 /30Days |
ISTURISA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISTURISA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:180 /30Days |
ISTURISA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover ISTURISA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:60 /30Days |
ITRACONAZOLE 10 MG/ML SOLUTION [Sporanox] ![Compare how all Medicare Part D PDP plans in NY cover ITRACONAZOLE 10 MG/ML SOLUTION [Sporanox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
ITRACONAZOLE 100 MG CAPSULE [Sporanox] ![Compare how all Medicare Part D PDP plans in NY cover ITRACONAZOLE 100 MG CAPSULE [Sporanox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
IVERMECTIN 1% CREAM (G) [Soolantra] ![Compare how all Medicare Part D PDP plans in NY cover IVERMECTIN 1% CREAM (G) [Soolantra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |
IVERMECTIN 3 MG TABLET [Stromectol, Sklice] ![Compare how all Medicare Part D PDP plans in NY cover IVERMECTIN 3 MG TABLET [Stromectol, Sklice].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$15.00 | $30.00 | None |
Ixekizumab 1ML 80 MG/ML Auto-Injector [Taltz] ![Compare how all Medicare Part D PDP plans in NY cover Ixekizumab 1ML 80 MG/ML Auto-Injector [Taltz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:4 /28Days |
Ixekizumab 1ML 80 MG/ML Prefilled Syringe [Taltz] ![Compare how all Medicare Part D PDP plans in NY cover Ixekizumab 1ML 80 MG/ML Prefilled Syringe [Taltz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | 26% | P Q:4 /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 NY cover IXIARO 6 UNIT(6 MCG)/0.5ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
28% | 28% | None |