2023 Medicare Part D Plan Formulary Information |
Clear Spring Health Premier Rx (PDP) (S6946-051-0)
Sanctioned Plan
 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 Clear Spring Health Premier Rx (PDP) (S6946-051-0) Formulary Drugs Starting with the Letter F in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY
|
Drugs Starting with Letter F
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
FALMINA-28 TABLET [Vienva] ![Compare how all Medicare Part D PDP plans in IA cover FALMINA-28 TABLET [Vienva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FAMCICLOVIR 125 MG TABLET  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FAMCICLOVIR 250 MG TABLET [Famvir] ![Compare how all Medicare Part D PDP plans in IA cover FAMCICLOVIR 250 MG TABLET [Famvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FAMCICLOVIR 500 MG TABLET [Famvir] ![Compare how all Medicare Part D PDP plans in IA cover FAMCICLOVIR 500 MG TABLET [Famvir].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FAMOTIDINE 20 MG TABLET [Zantac 360] ![Compare how all Medicare Part D PDP plans in IA cover FAMOTIDINE 20 MG TABLET [Zantac 360].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FAMOTIDINE 40 MG TABLET [Pepcid] ![Compare how all Medicare Part D PDP plans in IA cover FAMOTIDINE 40 MG TABLET [Pepcid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FAMOTIDINE 50 MG/5MLFOR ORAL SUSPENSION  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FANAPT 1 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:60 /30Days |
FANAPT 10 MG TABLET  |
5 |
Specialty Tier |
25% | 25% | S Q:60 /30Days |
FANAPT 12 MG TABLET  |
5 |
Specialty Tier |
25% | 25% | S Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FANAPT 2 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:60 /30Days |
FANAPT 4 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:60 /30Days |
FANAPT 6 MG TABLET  |
5 |
Specialty Tier |
25% | 25% | S Q:60 /30Days |
FANAPT 8 MG TABLET  |
5 |
Specialty Tier |
25% | 25% | S Q:60 /30Days |
FANAPT TITR TABLETS  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:8 /180Days |
FEBUXOSTAT 40 MG TABLET [Uloric] ![Compare how all Medicare Part D PDP plans in IA cover FEBUXOSTAT 40 MG TABLET [Uloric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | S |
FEBUXOSTAT 80 MG TABLET [Uloric] ![Compare how all Medicare Part D PDP plans in IA cover FEBUXOSTAT 80 MG TABLET [Uloric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | S |
FELBAMATE 400 MG TABLET [Felbatol] ![Compare how all Medicare Part D PDP plans in IA cover FELBAMATE 400 MG TABLET [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FELBAMATE 600 MG TABLET [Felbatol] ![Compare how all Medicare Part D PDP plans in IA cover FELBAMATE 600 MG TABLET [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol] ![Compare how all Medicare Part D PDP plans in IA cover FELBAMATE 600 MG/5 ML ORAL SUSPENSION [Felbatol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
FELODIPINE ER 10 MG TABLET  |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil] ![Compare how all Medicare Part D PDP plans in IA cover FELODIPINE ER 2.5 MG TABLET ER 24H [Plendil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
FELODIPINE ER 5 MG TABLET  |
2* |
Generic |
$5.00 | $15.00 | None |
FENOFIBRATE 134 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 134 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FENOFIBRATE 145 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 145 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FENOFIBRATE 160 MG TABLET [Triglide] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 160 MG TABLET [Triglide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
FENOFIBRATE 200 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 200 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
FENOFIBRATE 48 MG TABLET [Tricor] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 48 MG TABLET [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:60 /30Days |
FENOFIBRATE 54 MG TABLET [Lofibra] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 54 MG TABLET [Lofibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:60 /30Days |
FENOFIBRATE 67 MG CAPSULE [Tricor] ![Compare how all Medicare Part D PDP plans in IA cover FENOFIBRATE 67 MG CAPSULE [Tricor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
FENTANYL 100 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL 100 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P Q:10 /30Days |
FENTANYL 12 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL 12 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P Q:10 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FENTANYL 25 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL 25 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P Q:10 /30Days |
FENTANYL 50 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL 50 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P Q:10 /30Days |
FENTANYL 75 MCG/HR PATCH TD72 [Duragesic] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL 75 MCG/HR PATCH TD72 [Duragesic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P Q:10 /30Days |
FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL CIT OTFC 1,200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL CIT OTFC 1,600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL CITRATE OTFC 200 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P Q:120 /30Days |
FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL CITRATE OTFC 400 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL CITRATE OTFC 600 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq] ![Compare how all Medicare Part D PDP plans in IA cover FENTANYL CITRATE OTFC 800 MCG LOZENGE HD [Actiq].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:120 /30Days |
FERRIPROX 100 MG/ML SOLUTION  |
5 |
Specialty Tier |
25% | 25% | P |
FESOTERODINE ER 4 MG TABLET 24H [Toviaz] ![Compare how all Medicare Part D PDP plans in IA cover FESOTERODINE ER 4 MG TABLET 24H [Toviaz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FESOTERODINE ER 8 MG TABLET 24H [Toviaz] ![Compare how all Medicare Part D PDP plans in IA cover FESOTERODINE ER 8 MG TABLET 24H [Toviaz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FETZIMA 20-40 MG TITRATION PAK  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:28 /180Days |
FETZIMA ER 120 MG CAPSULE  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FETZIMA ER 20 MG CAPSULE  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FETZIMA ER 40 MG CAPSULE  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FETZIMA ER 80 MG CAPSULE  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN  |
3 |
Preferred Brand |
$35 max* | $126.00 | None |
FIASP 100 UNIT/ML VIAL  |
3 |
Preferred Brand |
$35 max* | $126.00 | None |
FIASP PENFILL 100 UNIT/ML CART CARTRIDGE  |
3 |
Preferred Brand |
$35 max* | $126.00 | None |
FINASTERIDE 5 MG TABLET [Proscar] ![Compare how all Medicare Part D PDP plans in IA cover FINASTERIDE 5 MG TABLET [Proscar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FINGOLIMOD 0.5 MG CAPSULE [Gilenya] ![Compare how all Medicare Part D PDP plans in IA cover FINGOLIMOD 0.5 MG CAPSULE [Gilenya].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FINTEPLA 2.2 MG/ML SOLUTION  |
5 |
Specialty Tier |
25% | 25% | P Q:360 /30Days |
FIRDAPSE 10 MG TABLET  |
5 |
Specialty Tier |
25% | 25% | P Q:240 /30Days |
FIRVANQ 25 MG/ML SOLUTION SOLUTION RECON  |
4 |
Non-Preferred Drug |
45% | 45% | Q:450 /10Days |
FLAC OTIC OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in IA cover FLAC OTIC OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
FLECAINIDE ACETATE 100 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in IA cover FLECAINIDE ACETATE 100 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLECAINIDE ACETATE 150 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in IA cover FLECAINIDE ACETATE 150 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLECAINIDE ACETATE 50 MG TABLET [Tambocor] ![Compare how all Medicare Part D PDP plans in IA cover FLECAINIDE ACETATE 50 MG TABLET [Tambocor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLOVENT DISKUS 100ug/1 60 POWDER, METERED in 1 INHALER  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
FLOVENT DISKUS 250ug/1 60 POWDER, METERED in 1 INHALER  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:240 /30Days |
FLOVENT DISKUS POWDER 50MCG 60 CTR  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:12 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLOVENT HFA 220ug/1 120 AEROSOL, METERED in 1 INHALER  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:24 /30Days |
FLOVENT HFA 44ug/1 120 AEROSOL, METERED in 1 INHALER  |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:11 /30Days |
FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE 10 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUCONAZOLE 100 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE 100 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUCONAZOLE 150 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE 150 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FLUCONAZOLE 200 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE 200 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE 40 MG/ML ORAL SUSPENSION [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUCONAZOLE 50 MG TABLET [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE 50 MG TABLET [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE-NACL 200 MG/100 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P |
FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan] ![Compare how all Medicare Part D PDP plans in IA cover FLUCONAZOLE-NACL 400 MG/200 ML PIGGYBACK [Diflucan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P |
FLUCYTOSINE 250 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in IA cover FLUCYTOSINE 250 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUCYTOSINE 500 MG CAPSULE [Ancobon] ![Compare how all Medicare Part D PDP plans in IA cover FLUCYTOSINE 500 MG CAPSULE [Ancobon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
FLUDROCORTISONE 0.1 MG TABLET [Florinef] ![Compare how all Medicare Part D PDP plans in IA cover FLUDROCORTISONE 0.1 MG TABLET [Florinef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUNISOLIDE NASAL SOLUTION 0.025% 25ML INHL  |
4 |
Non-Preferred Drug |
45% | 45% | Q:50 /30Days |
FLUOCINOLONE 0.01% CREAM (G)  |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOCINOLONE 0.01% SOLUTION [Synalar] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINOLONE 0.01% SOLUTION [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOCINOLONE 0.025% CREAM (G) [Synalar] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINOLONE 0.025% CREAM (G) [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOCINOLONE 0.025% OINTMENT [Synalar] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINOLONE 0.025% OINTMENT [Synalar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOCINOLONE OIL 0.01% EAR DROPS [Flac] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINOLONE OIL 0.01% EAR DROPS [Flac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOCINONIDE 0.05% GEL [Lidex] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINONIDE 0.05% GEL [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | Q:120 /30Days |
FLUOCINONIDE 0.05% OINTMENT [Lidex] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINONIDE 0.05% OINTMENT [Lidex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | Q:120 /30Days |
FLUOCINONIDE 0.05% SOLUTION  |
4 |
Non-Preferred Drug |
45% | 45% | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUOCINONIDE-E 0.05% CREAM (G) [Lidex -E] ![Compare how all Medicare Part D PDP plans in IA cover FLUOCINONIDE-E 0.05% CREAM (G) [Lidex -E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | Q:120 /30Days |
Fluorometholone 0.1% drops  |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOROURACIL 2% TOPICAL SOLUTION  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUOROURACIL 5% CREAM (g) [Efudex] ![Compare how all Medicare Part D PDP plans in IA cover FLUOROURACIL 5% CREAM (g) [Efudex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOROURACIL 5% TOPICAL SOLUTION  |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOXETINE 20 MG/5 ML SOLUTION [Prozac] ![Compare how all Medicare Part D PDP plans in IA cover FLUOXETINE 20 MG/5 ML SOLUTION [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUOXETINE HCL 10 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in IA cover FLUOXETINE HCL 10 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
FLUOXETINE HCL 10 MG TABLET [Sarafem] ![Compare how all Medicare Part D PDP plans in IA cover FLUOXETINE HCL 10 MG TABLET [Sarafem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:240 /30Days |
FLUOXETINE HCL 20 MG CAPSULE  |
2* |
Generic |
$5.00 | $15.00 | Q:90 /30Days |
FLUOXETINE HCL 40 MG CAPSULE [Prozac] ![Compare how all Medicare Part D PDP plans in IA cover FLUOXETINE HCL 40 MG CAPSULE [Prozac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:60 /30Days |
FLUPHENAZINE 1 MG TABLET  |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUPHENAZINE 10 MG TABLET [Prolixin] ![Compare how all Medicare Part D PDP plans in IA cover FLUPHENAZINE 10 MG TABLET [Prolixin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
FLUPHENAZINE 2.5 MG TABLET  |
2* |
Generic |
$5.00 | $15.00 | None |
FLUPHENAZINE 2.5 MG/5 ML ELIXIR [Prolixin] ![Compare how all Medicare Part D PDP plans in IA cover FLUPHENAZINE 2.5 MG/5 ML ELIXIR [Prolixin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUPHENAZINE 2.5MG/ML VIAL  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUPHENAZINE 5 MG TABLET  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUPHENAZINE 5MG/ML CONC  |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate] ![Compare how all Medicare Part D PDP plans in IA cover FLUPHENAZINE DEC 125 MG/5 ML VIAL [Prolixin Decanoate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FLURBIPROFEN 0.03% EYE DROPS [Ocufen] ![Compare how all Medicare Part D PDP plans in IA cover FLURBIPROFEN 0.03% EYE DROPS [Ocufen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
Flurbiprofen 100mg/1 100 BOTTLE in 1 BOTTLE / 100 FILM COATED TABLETS in BOTTLE  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FLUTICASONE PROP 0.005% OINTMENT [Cutivate] ![Compare how all Medicare Part D PDP plans in IA cover FLUTICASONE PROP 0.005% OINTMENT [Cutivate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Fluticasone Propionate 0.5mg/g 1 TUBE per CARTON / 30 g in 1 TUBE  |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FLUTICASONE PROPIONATE 50 MCG SPRAY SUSPENSION  |
2* |
Generic |
$5.00 | $15.00 | Q:16 /30Days |
FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in IA cover FLUTICASONE-SALMETEROL 113-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:1 /30Days |
FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in IA cover FLUTICASONE-SALMETEROL 232-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:1 /30Days |
FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK] ![Compare how all Medicare Part D PDP plans in IA cover FLUTICASONE-SALMETEROL 55-14 [Advair Diskus, Advair HFA, AIRDUO RESPICLICK].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:1 /30Days |
FLUVOXAMINE MALEATE 100 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in IA cover FLUVOXAMINE MALEATE 100 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:90 /30Days |
FLUVOXAMINE MALEATE 25 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in IA cover FLUVOXAMINE MALEATE 25 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days |
FLUVOXAMINE MALEATE 50 MG TABLET [Luvox] ![Compare how all Medicare Part D PDP plans in IA cover FLUVOXAMINE MALEATE 50 MG TABLET [Luvox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days |
FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in IA cover FONDAPARINUX 10 MG/0.8 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | Q:14 /28Days |
FONDAPARINUX 2.5 MG/0.5 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in IA cover FONDAPARINUX 2.5 MG/0.5 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | Q:18 /35Days |
FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in IA cover FONDAPARINUX 5 MG/0.4 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | None |
FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra] ![Compare how all Medicare Part D PDP plans in IA cover FONDAPARINUX 7.5 MG/0.6 ML SYRINGE [Arixtra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | Q:14 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FOSAMPRENAVIR 700 MG TABLET [Lexiva] ![Compare how all Medicare Part D PDP plans in IA cover FOSAMPRENAVIR 700 MG TABLET [Lexiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | Q:120 /30Days |
FOSINOPRIL SODIUM 10 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in IA cover FOSINOPRIL SODIUM 10 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FOSINOPRIL SODIUM 20 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in IA cover FOSINOPRIL SODIUM 20 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FOSINOPRIL SODIUM 40 MG TABLET [Monopril] ![Compare how all Medicare Part D PDP plans in IA cover FOSINOPRIL SODIUM 40 MG TABLET [Monopril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in IA cover FOSINOPRIL-HCTZ 10-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT] ![Compare how all Medicare Part D PDP plans in IA cover FOSINOPRIL-HCTZ 20-12.5 MG TABLET [Monopril-HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
FOTIVDA 0.89 MG CAPSULE  |
5 |
Specialty Tier |
25% | 25% | P Q:21 /28Days |
FOTIVDA 1.34 MG CAPSULE  |
5 |
Specialty Tier |
25% | 25% | P Q:21 /28Days |
FUROSEMIDE 10 MG/ML SOLUTION  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FUROSEMIDE 100 MG/10 ML VIAL  |
3 |
Preferred Brand |
$42.00 | $126.00 | None |
FUROSEMIDE 20 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in IA cover FUROSEMIDE 20 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FUROSEMIDE 40 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in IA cover FUROSEMIDE 40 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FUROSEMIDE 40MG/5ML TUBEX  |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FUROSEMIDE 80 MG TABLET [Lasix] ![Compare how all Medicare Part D PDP plans in IA cover FUROSEMIDE 80 MG TABLET [Lasix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
FUZEON 90 MG VIAL  |
5 |
Specialty Tier |
25% | 25% | Q:60 /30Days |
FYAVOLV 0.5 MG-2.5 MCG TABLET [Jevantique] ![Compare how all Medicare Part D PDP plans in IA cover FYAVOLV 0.5 MG-2.5 MCG TABLET [Jevantique].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P |
FYAVOLV 1 MG-5 MCG TABLET [Jinteli 1/5] ![Compare how all Medicare Part D PDP plans in IA cover FYAVOLV 1 MG-5 MCG TABLET [Jinteli 1/5].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
45% | 45% | P |
FYCOMPA 0.5 MG/ML ORAL SUSP  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:720 /30Days |
FYCOMPA 10 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:30 /30Days |
FYCOMPA 12 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:30 /30Days |
FYCOMPA 2 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:60 /30Days |
FYCOMPA 4 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
FYCOMPA 6 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:60 /30Days |
FYCOMPA 8 MG TABLET  |
4 |
Non-Preferred Drug |
45% | 45% | S Q:30 /30Days |