2023 Medicare Part D Plan Formulary Information |
RiverSpring Star (HMO I-SNP) (H6776-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for RiverSpring Star (HMO I-SNP). 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 RiverSpring Star (HMO I-SNP) (H6776-001-0) Formulary Drugs Starting with the Letter H in Bronx County, NY: CMS MA Region 3 which includes: NY
|
Drugs Starting with Letter H
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
H.P. ACTHAR GEL 80 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover H.P. ACTHAR GEL 80 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HADLIMA(CF) 40 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HADLIMA(CF) 40 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:6 /28Days |
HADLIMA(CF) PUSHTOUCH 40MG/0.4 AUTO INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover HADLIMA(CF) PUSHTOUCH 40MG/0.4 AUTO INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
HAEGARDA 2,000 UNIT VIAL ![Compare how all Medicare Part D PDP plans in NY cover HAEGARDA 2,000 UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HAEGARDA 3,000 UNIT VIAL ![Compare how all Medicare Part D PDP plans in NY cover HAEGARDA 3,000 UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HAILEY 24 FE 1 MG-20 MCG TABLET [Tarina Fe 1/20] ![Compare how all Medicare Part D PDP plans in NY cover HAILEY 24 FE 1 MG-20 MCG TABLET [Tarina Fe 1/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALCINONIDE 0.1% CREAM (g) [Halog -E] ![Compare how all Medicare Part D PDP plans in NY cover HALCINONIDE 0.1% CREAM (g) [Halog -E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALDOL DECANOATE 100MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in NY cover HALDOL DECANOATE 100MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALDOL DECANOATE 50MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in NY cover HALDOL DECANOATE 50MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOBETASOL PROP 0.05% CREAM ![Compare how all Medicare Part D PDP plans in NY cover HALOBETASOL PROP 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HALOBETASOL PROP 0.05% FOAM [LEXETTE] ![Compare how all Medicare Part D PDP plans in NY cover HALOBETASOL PROP 0.05% FOAM [LEXETTE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Halobetasol Propionate 0.5mg/g 1 TUBE per CARTON / 50 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NY cover Halobetasol Propionate 0.5mg/g 1 TUBE per CARTON / 50 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOG 0.1% SOLUTION ![Compare how all Medicare Part D PDP plans in NY cover HALOG 0.1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Halog 1mg/g 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in NY cover Halog 1mg/g 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOG OINTMENT 1mg/g 60 g in 1 TUBE [HALOG] ![Compare how all Medicare Part D PDP plans in NY cover HALOG OINTMENT 1mg/g 60 g in 1 TUBE [HALOG].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL 0.5 MG TABLET [Haldol] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL 0.5 MG TABLET [Haldol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL 1 MG TABLET [Haldol] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL 1 MG TABLET [Haldol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL 2 MG TABLET [Haldol] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL 2 MG TABLET [Haldol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL 5 MG TABLET [Haldol] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL 5 MG TABLET [Haldol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HALOPERIDOL DEC 100 MG/ML VIAL [Haldol Decanoate] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL DEC 100 MG/ML VIAL [Haldol Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL DEC 50 MG/ML VIAL [Haldol Decanoate] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL DEC 50 MG/ML VIAL [Haldol Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL DEC 50 MG/ML VIAL [Haldol Decanoate] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL DEC 50 MG/ML VIAL [Haldol Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL DEC 500 MG/5 ML VIAL [Haldol Decanoate] ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL DEC 500 MG/5 ML VIAL [Haldol Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL LAC 2 MG/ML CONC ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL LAC 2 MG/ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HALOPERIDOL LAC 5 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HALOPERIDOL LAC 5 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HARVONI 33.75-150 MG PELLET PACKET ![Compare how all Medicare Part D PDP plans in NY cover HARVONI 33.75-150 MG PELLET PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:28 /28Days |
HARVONI 45-200 MG PELLET PACKET ![Compare how all Medicare Part D PDP plans in NY cover HARVONI 45-200 MG PELLET PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:56 /28Days |
HARVONI 90-400 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HARVONI 90-400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:28 /28Days |
HAVRIX 1,440 UNITS/ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HAVRIX 1,440 UNITS/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HAVRIX HEPATITIS A VACCINE INJECTION ![Compare how all Medicare Part D PDP plans in NY cover HAVRIX HEPATITIS A VACCINE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HEMADY 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HEMADY 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HEPARIN 10,000 UNIT/10 ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HEPARIN 10,000 UNIT/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HEPARIN SOD 20,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HEPARIN SOD 20,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HEPARIN SOD 5,000 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HEPARIN SOD 5,000 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HEPARIN SODIUM INJECTION ![Compare how all Medicare Part D PDP plans in NY cover HEPARIN SODIUM INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Hepatitis B Surface Antigen Vaccine 0.01 MG/ML Prefilled 0.5 ML Syringe [Recombivax] ![Compare how all Medicare Part D PDP plans in NY cover Hepatitis B Surface Antigen Vaccine 0.01 MG/ML Prefilled 0.5 ML Syringe [Recombivax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HEPLISAV-B 20 MCG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HEPLISAV-B 20 MCG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HETLIOZ 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover HETLIOZ 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:30 /30Days |
HETLIOZ LQ 4 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover HETLIOZ LQ 4 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:158 /30Days |
HIBERIX VACCINE WITH DILUENT ![Compare how all Medicare Part D PDP plans in NY cover HIBERIX VACCINE WITH DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HIPREX 1 GM TABLET ![Compare how all Medicare Part D PDP plans in NY cover HIPREX 1 GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HORIZANT ER 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HORIZANT ER 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:30 /30Days |
HORIZANT ER 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HORIZANT ER 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HULIO(CF) 20 MG/0.4 ML SYRINGE KIT ![Compare how all Medicare Part D PDP plans in NY cover HULIO(CF) 20 MG/0.4 ML SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
HULIO(CF) 40 MG/0.8 ML SYRINGE KIT ![Compare how all Medicare Part D PDP plans in NY cover HULIO(CF) 40 MG/0.8 ML SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:6 /28Days |
HULIO(CF) PEN 40 MG/0.8 ML PEN INJECTOR KIT ![Compare how all Medicare Part D PDP plans in NY cover HULIO(CF) PEN 40 MG/0.8 ML PEN INJECTOR KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:6 /28Days |
HUMALOG 100 UNIT/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG 100 UNIT/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG 100 UNITS/ML CARTRIDGE ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG 100 UNITS/ML CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG 200 UNITS/ML KWIKPEN ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG 200 UNITS/ML KWIKPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG JR 100 UNIT/ML KWIKPEN ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG JR 100 UNIT/ML KWIKPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG KWIKPEN INJECTION ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG KWIKPEN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG MIX 50/50 VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG MIX 50/50 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HUMALOG MIX 75/25 VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG MIX 75/25 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG MIX KWIKPEN INJECTION ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG MIX KWIKPEN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG MIX KWIKPEN INJECTION SUSPENSION ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG MIX KWIKPEN INJECTION SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMALOG TEMPO PEN 100 UNIT/ML INSULN PEN ![Compare how all Medicare Part D PDP plans in NY cover HUMALOG TEMPO PEN 100 UNIT/ML INSULN PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | S |
HUMATIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover HUMATIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HUMATROPE 12MG CARTRIDGE ![Compare how all Medicare Part D PDP plans in NY cover HUMATROPE 12MG CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HUMATROPE 24MG CARTRIDGE ![Compare how all Medicare Part D PDP plans in NY cover HUMATROPE 24MG CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HUMATROPE 6MG CARTRIDGE ![Compare how all Medicare Part D PDP plans in NY cover HUMATROPE 6MG CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HUMIRA 10 MG/0.1 ML SYRINGEKIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA 10 MG/0.1 ML SYRINGEKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
Humira 2 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in NY cover Humira 2 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
HUMIRA 20 MG/0.2 ML SYRINGEKIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA 20 MG/0.2 ML SYRINGEKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HUMIRA 40 MG/0.4 ML PEN IJ KIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA 40 MG/0.4 ML PEN IJ KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
HUMIRA 40 MG/0.4 ML SYRINGEKIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA 40 MG/0.4 ML SYRINGEKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
HUMIRA 40 MG/0.8 ML PEN ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA 40 MG/0.8 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /28Days |
HUMIRA PED CROHNS 80 MG/0.8 ML SYRINGEKIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA PED CROHNS 80 MG/0.8 ML SYRINGEKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:3 /180Days |
HUMIRA PEDIATR CROHN'S 80-40MG SYRINGEKIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA PEDIATR CROHN'S 80-40MG SYRINGEKIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /180Days |
HUMIRA PEN KIT 40MG-70% 1 PKGCOM ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA PEN KIT 40MG-70% 1 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:6 /180Days |
HUMIRA PEN PSORIASIS-UVEITIS ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA PEN PSORIASIS-UVEITIS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /180Days |
HUMIRA(CF) PEN 80 MG/0.8 ML PEN IJ KIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA(CF) PEN 80 MG/0.8 ML PEN IJ KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
HUMIRA(CF) PEN CRHN-UC-HS 80MG PEN IJ KIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA(CF) PEN CRHN-UC-HS 80MG PEN IJ KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:3 /180Days |
HUMIRA(CF) PEN PEDI UC 80 MG PEN IJ KIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA(CF) PEN PEDI UC 80 MG PEN IJ KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:4 /180Days |
HUMIRA(CF) PEN PS-UV-AHS 80-40 PEN IJ KIT ![Compare how all Medicare Part D PDP plans in NY cover HUMIRA(CF) PEN PS-UV-AHS 80-40 PEN IJ KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:3 /180Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HUMULIN 70/30 KWIKPEN ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN 70/30 KWIKPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMULIN 70/30 VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN 70/30 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMULIN N 100 UNITS/ML KWIKPEN ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN N 100 UNITS/ML KWIKPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMULIN N 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN N 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMULIN R 100U/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN R 100U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMULIN R 500 UNITS/ML KWIKPEN ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN R 500 UNITS/ML KWIKPEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HUMULIN R 500U/ML VIAL ![Compare how all Medicare Part D PDP plans in NY cover HUMULIN R 500U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$35 max* | 25% | None |
HYDRALAZINE 10 MG TABLET [Apresoline] ![Compare how all Medicare Part D PDP plans in NY cover HYDRALAZINE 10 MG TABLET [Apresoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDRALAZINE 100 MG TABLET [Apresoline] ![Compare how all Medicare Part D PDP plans in NY cover HYDRALAZINE 100 MG TABLET [Apresoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDRALAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDRALAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDRALAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDRALAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDREA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover HYDREA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE [Microzide] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE [Microzide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCHLOROTHIAZIDE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDROCHLOROTHIAZIDE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCHLOROTHIAZIDE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDROCHLOROTHIAZIDE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCHLOROTHIAZIDE 50 MG TABLET [Zide] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCHLOROTHIAZIDE 50 MG TABLET [Zide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCODONE ER 10 MG CAPSULE 12H [Zohydro] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 10 MG CAPSULE 12H [Zohydro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
HYDROCODONE ER 100 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 100 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROCODONE ER 120 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 120 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROCODONE ER 15 MG CAPSULE 12H [Zohydro] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 15 MG CAPSULE 12H [Zohydro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
HYDROCODONE ER 20 MG CAPSULE 12H [Zohydro] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 20 MG CAPSULE 12H [Zohydro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
HYDROCODONE ER 20 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 20 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROCODONE ER 30 MG CAPSULE 12H [Zohydro] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 30 MG CAPSULE 12H [Zohydro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
HYDROCODONE ER 30 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 30 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROCODONE ER 40 MG CAPSULE 12H [Zohydro] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 40 MG CAPSULE 12H [Zohydro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
HYDROCODONE ER 40 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 40 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROCODONE ER 50 MG CAPSULE 12H [Zohydro] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 50 MG CAPSULE 12H [Zohydro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:90 /30Days |
HYDROCODONE ER 60 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 60 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROCODONE ER 80 MG TABLET 24H [Hysingla ER] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE ER 80 MG TABLET 24H [Hysingla ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROCODONE-ACETAMIN 10-300 MG TABLET [Xodol] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMIN 10-300 MG TABLET [Xodol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:390 /30Days |
HYDROCODONE-ACETAMIN 10-325 MG TABLET [Norco] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMIN 10-325 MG TABLET [Norco].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:360 /30Days |
HYDROCODONE-ACETAMIN 5-300 MG TABLET [Xodol] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMIN 5-300 MG TABLET [Xodol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:390 /30Days |
HYDROCODONE-ACETAMIN 5-325 MG TABLET [Norco] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMIN 5-325 MG TABLET [Norco].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROCODONE-ACETAMIN 7.5-300 TABLET [Xodol] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMIN 7.5-300 TABLET [Xodol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:390 /30Days |
HYDROCODONE-ACETAMIN 7.5-325 TABLET [Norco] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMIN 7.5-325 TABLET [Norco].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:360 /30Days |
HYDROCODONE-ACETAMN 7.5-325/15 SOLUTION [Hycet] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-ACETAMN 7.5-325/15 SOLUTION [Hycet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:5550 /30Days |
HYDROCODONE-IBUPROFEN 10-200 TABLET [Xylon 10] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-IBUPROFEN 10-200 TABLET [Xylon 10].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:50 /30Days |
HYDROCODONE-IBUPROFEN 5-200 MG ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-IBUPROFEN 5-200 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:50 /30Days |
HYDROCODONE-IBUPROFEN 7.5-200 TABLET [Vicoprofen] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCODONE-IBUPROFEN 7.5-200 TABLET [Vicoprofen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:50 /30Days |
HYDROCORT-PRAMOXINE 1%-1% CREAM w/APPL [Zone A] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORT-PRAMOXINE 1%-1% CREAM w/APPL [Zone A].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISON-ACETIC ACID SOLUTION DROPS [VoSoL HC] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISON-ACETIC ACID SOLUTION DROPS [VoSoL HC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 1% CREAM ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 1% OINTMENT ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 10 MG TABLET [Hydrocortone] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 10 MG TABLET [Hydrocortone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Hydrocortisone 10 MG/ML Topical Cream [Ala-Cort] ![Compare how all Medicare Part D PDP plans in NY cover Hydrocortisone 10 MG/ML Topical Cream [Ala-Cort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 100 MG/60 ML ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 100 MG/60 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 2.5% CREAM /PE APP [Proctozone-HC] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 2.5% CREAM /PE APP [Proctozone-HC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 2.5% LOTION ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 2.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 2.5% OINTMENT ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 2.5% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 20 MG TABLET [Cortef] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 20 MG TABLET [Cortef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE 5 MG TABLET [Cortef] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE 5 MG TABLET [Cortef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE BUTY 0.1% CREAM (G) [Locoid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE BUTY 0.1% CREAM (G) [Locoid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:120 /30Days |
HYDROCORTISONE BUTYR 0.1% LOTION [Locoid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE BUTYR 0.1% LOTION [Locoid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:118 /30Days |
HYDROCORTISONE BUTYR 0.1% OINTMENT [Locoid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE BUTYR 0.1% OINTMENT [Locoid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:120 /30Days |
HYDROCORTISONE BUTYR 0.1% SOLUTION [Locoid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE BUTYR 0.1% SOLUTION [Locoid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROCORTISONE VAL 0.2% CREAM (G) [Westcort] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE VAL 0.2% CREAM (G) [Westcort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROCORTISONE VAL 0.2% OINTMENT [Westcort] ![Compare how all Medicare Part D PDP plans in NY cover HYDROCORTISONE VAL 0.2% OINTMENT [Westcort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROMORPHONE 1 MG/ML SOLUTION LIQUID [Dilaudid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE 1 MG/ML SOLUTION LIQUID [Dilaudid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:2400 /30Days |
HYDROMORPHONE 10 MG/ML VIAL [Dilaudid-HP] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE 10 MG/ML VIAL [Dilaudid-HP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROMORPHONE 2 MG TABLET [Dilaudid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE 2 MG TABLET [Dilaudid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:180 /30Days |
HYDROMORPHONE 4 MG TABLET [Dilaudid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE 4 MG TABLET [Dilaudid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:180 /30Days |
HYDROMORPHONE 50 MG/5 ML VIAL [Dilaudid-HP] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE 50 MG/5 ML VIAL [Dilaudid-HP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROMORPHONE 8 MG TABLET [Dilaudid] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE 8 MG TABLET [Dilaudid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | Q:180 /30Days |
HYDROMORPHONE HCL ER 12 MG TABLET 24H [Exalgo] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE HCL ER 12 MG TABLET 24H [Exalgo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROMORPHONE HCL ER 16 MG TABLET 24H [Exalgo] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE HCL ER 16 MG TABLET 24H [Exalgo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROMORPHONE HCL ER 32 MG TABLET 24H [Exalgo] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE HCL ER 32 MG TABLET 24H [Exalgo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYDROMORPHONE HCL ER 8 MG TABLET 24H [Exalgo] ![Compare how all Medicare Part D PDP plans in NY cover HYDROMORPHONE HCL ER 8 MG TABLET 24H [Exalgo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYDROXYCHLOROQUINE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYCHLOROQUINE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROXYCHLOROQUINE 200 MG TABLET [Quineprox] ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYCHLOROQUINE 200 MG TABLET [Quineprox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROXYCHLOROQUINE 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYCHLOROQUINE 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROXYCHLOROQUINE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYCHLOROQUINE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROXYUREA 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYUREA 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | None |
HYDROXYZINE HCL 10 MG TABLET [Rezine] ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYZINE HCL 10 MG TABLET [Rezine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HYDROXYZINE HCL 25 MG TABLET [Atarax] ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYZINE HCL 25 MG TABLET [Atarax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HYDROXYZINE HCL 50 MG TABLET [Atarax] ![Compare how all Medicare Part D PDP plans in NY cover HYDROXYZINE HCL 50 MG TABLET [Atarax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HYFTOR 0.2% GEL ![Compare how all Medicare Part D PDP plans in NY cover HYFTOR 0.2% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HYRIMOZ(CF) 10 MG/0.1 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) 10 MG/0.1 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYRIMOZ(CF) 20 MG/0.2 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) 20 MG/0.2 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P |
HYRIMOZ(CF) 40 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) 40 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
HYRIMOZ(CF) PEDI CROHN 80-40MG SYRINGE ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) PEDI CROHN 80-40MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:1 /180Days |
HYRIMOZ(CF) PEN 40 MG/0.4 ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) PEN 40 MG/0.4 ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
HYRIMOZ(CF) PEN 80 MG/0.8 ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) PEN 80 MG/0.8 ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /28Days |
HYRIMOZ(CF) PEN CROHN-UC 80 MG PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) PEN CROHN-UC 80 MG PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /180Days |
HYRIMOZ(CF) PEN PSORIA 80-40MG PEN INJECTOR ![Compare how all Medicare Part D PDP plans in NY cover HYRIMOZ(CF) PEN PSORIA 80-40MG PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:2 /180Days |
HYSINGLA ER 100 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYSINGLA ER 120 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYSINGLA ER 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYSINGLA ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
HYSINGLA ER 40 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYSINGLA ER 60 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYSINGLA ER 80 MG TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYSINGLA ER 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | P Q:60 /30Days |
HYZAAR 100-12.5 TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYZAAR 100-12.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | S |
HYZAAR 100-25 TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYZAAR 100-25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | S |
HYZAAR 50-12.5 TABLET ![Compare how all Medicare Part D PDP plans in NY cover HYZAAR 50-12.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
25% | 25% | S |