2024 Medicare Part D Plan Formulary Information |
HealthPartners UnityPoint Health Symmetry (PPO) (H3416-002-4)
Benefits & Contact Info
![Email Prescription and/or Health Benefit details for HealthPartners UnityPoint Health Symmetry (PPO). 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 HealthPartners UnityPoint Health Symmetry (PPO) (H3416-002-4) Formulary Drugs Starting with the Letter C in Warren County, IA: CMS MA Region 19 which includes: IA
|
Drugs Starting with Letter C
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
CABERGOLINE 0.5 MG TABLET [Dostinex] ![Compare how all Medicare Part D PDP plans in IA cover CABERGOLINE 0.5 MG TABLET [Dostinex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CABLIVI 11 MG KIT ![Compare how all Medicare Part D PDP plans in IA cover CABLIVI 11 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CABOMETYX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CABOMETYX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CABOMETYX 40 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CABOMETYX 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CABOMETYX 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CABOMETYX 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CALCIPOTRIENE 0.005% CREAM (G) [Dovonex] ![Compare how all Medicare Part D PDP plans in IA cover CALCIPOTRIENE 0.005% CREAM (G) [Dovonex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:120 /30Days |
CALCIPOTRIENE 0.005% OINTMENT [Dovonex] ![Compare how all Medicare Part D PDP plans in IA cover CALCIPOTRIENE 0.005% OINTMENT [Dovonex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:120 /30Days |
CALCIPOTRIENE 0.005% SOLUTION [Dovonex Scalp] ![Compare how all Medicare Part D PDP plans in IA cover CALCIPOTRIENE 0.005% SOLUTION [Dovonex Scalp].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:120 /30Days |
CALCITONIN SALMON NASAL SPRAY 200IU/SPRY ![Compare how all Medicare Part D PDP plans in IA cover CALCITONIN SALMON NASAL SPRAY 200IU/SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CALCITRIOL 0.25 MCG CAPSULE [Rocaltrol] ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 0.25 MCG CAPSULE [Rocaltrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CALCITRIOL 0.5 MCG CAPSULE [Rocaltrol] ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 0.5 MCG CAPSULE [Rocaltrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CALCITRIOL 1 MCG/ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 1 MCG/ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CALCITRIOL 3 MCG/G OINTMENT ![Compare how all Medicare Part D PDP plans in IA cover CALCITRIOL 3 MCG/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CALCIUM ACETATE 667 MG CAPSULE [PhosLo] ![Compare how all Medicare Part D PDP plans in IA cover CALCIUM ACETATE 667 MG CAPSULE [PhosLo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CALCIUM ACETATE 667 MG TABLET [PhosLo] ![Compare how all Medicare Part D PDP plans in IA cover CALCIUM ACETATE 667 MG TABLET [PhosLo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CALQUENCE 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CALQUENCE 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CAMILA 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in IA cover CAMILA 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CANDESARTAN CILEXETIL 16 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in IA cover CANDESARTAN CILEXETIL 16 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CANDESARTAN CILEXETIL 32 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in IA cover CANDESARTAN CILEXETIL 32 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CANDESARTAN CILEXETIL 4 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in IA cover CANDESARTAN CILEXETIL 4 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CANDESARTAN CILEXETIL 8 MG TABLET [Atacand] ![Compare how all Medicare Part D PDP plans in IA cover CANDESARTAN CILEXETIL 8 MG TABLET [Atacand].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CAPLYTA 10.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CAPLYTA 10.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CAPLYTA 21 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CAPLYTA 21 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CAPLYTA 42 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CAPLYTA 42 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CAPRELSA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPRELSA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CAPRELSA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPRELSA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CAPTOPRIL 100 MG TABLET [Capoten] ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 100 MG TABLET [Capoten].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CAPTOPRIL 12.5 MG TABLET [Capoten] ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 12.5 MG TABLET [Capoten].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CAPTOPRIL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CAPTOPRIL 50 MG TABLET [Capoten] ![Compare how all Medicare Part D PDP plans in IA cover CAPTOPRIL 50 MG TABLET [Capoten].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBAMAZEPINE 100 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE 100 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CARBAMAZEPINE 100 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE 100 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBAMAZEPINE 200 MG TABLET [Tegretol] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE 200 MG TABLET [Tegretol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CARBAMAZEPINE ER 100 MG CAPSULE CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE ER 100 MG CAPSULE CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBAMAZEPINE ER 100 MG TABLET 12H [Tegretol -XR] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE ER 100 MG TABLET 12H [Tegretol -XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBAMAZEPINE ER 200 MG CAPSULE CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE ER 200 MG CAPSULE CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBAMAZEPINE ER 200 MG TABLET 12H [Tegretol -XR] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE ER 200 MG TABLET 12H [Tegretol -XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBAMAZEPINE ER 300 MG CAPSULE CPMP 12HR [Carbatrol] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE ER 300 MG CAPSULE CPMP 12HR [Carbatrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBAMAZEPINE ER 400 MG TABLET 12H [Tegretol -XR] ![Compare how all Medicare Part D PDP plans in IA cover CARBAMAZEPINE ER 400 MG TABLET 12H [Tegretol -XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVO 10-100 MG ODT TABLET RAPDIS [Parcopa] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO 10-100 MG ODT TABLET RAPDIS [Parcopa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVO 25-100 MG ODT TABLET RAPDIS [Parcopa] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO 25-100 MG ODT TABLET RAPDIS [Parcopa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVO 25-250 MG ODT TABLET RAPDIS [Parcopa] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO 25-250 MG ODT TABLET RAPDIS [Parcopa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVO ER 25-100 TABLET [SINEMET CR] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO ER 25-100 TABLET [SINEMET CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARBIDOPA-LEVO ER 50-200 TABLET [SINEMET CR] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVO ER 50-200 TABLET [SINEMET CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CARBIDOPA-LEVODOPA 10-100 TABLET [SINEMET] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 10-100 TABLET [SINEMET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARBIDOPA-LEVODOPA 100 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 100 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVODOPA 125 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 125 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVODOPA 150 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 150 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVODOPA 200 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 200 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVODOPA 25-100 TABLET [SINEMET] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 25-100 TABLET [SINEMET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARBIDOPA-LEVODOPA 25-250 TABLET ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 25-250 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARBIDOPA-LEVODOPA 50 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 50 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARBIDOPA-LEVODOPA 75 MG-ENTA TABLET [Stalevo] ![Compare how all Medicare Part D PDP plans in IA cover CARBIDOPA-LEVODOPA 75 MG-ENTA TABLET [Stalevo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARGLUMIC ACID 200 MG TABLET SUSP TABLET DISPER [Carbaglu] ![Compare how all Medicare Part D PDP plans in IA cover CARGLUMIC ACID 200 MG TABLET SUSP TABLET DISPER [Carbaglu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CARISOPRODOL 350 MG TABLET [Vanadom] ![Compare how all Medicare Part D PDP plans in IA cover CARISOPRODOL 350 MG TABLET [Vanadom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:4 /1Days |
CARNITOR 100MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in IA cover CARNITOR 100MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CARTEOLOL HCL 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover CARTEOLOL HCL 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARTIA XT 120MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 120MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARTIA XT 180 MG CAPSULE ER 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 180 MG CAPSULE ER 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARTIA XT 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CARTIA XT 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CARVEDILOL 12.5 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in IA cover CARVEDILOL 12.5 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARVEDILOL 25 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in IA cover CARVEDILOL 25 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARVEDILOL 3.125 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in IA cover CARVEDILOL 3.125 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CARVEDILOL 6.25 MG TABLET [Coreg] ![Compare how all Medicare Part D PDP plans in IA cover CARVEDILOL 6.25 MG TABLET [Coreg].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CASPOFUNGIN ACETATE 50 MG VIAL [Cancidas] ![Compare how all Medicare Part D PDP plans in IA cover CASPOFUNGIN ACETATE 50 MG VIAL [Cancidas].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CASPOFUNGIN ACETATE 70 MG VIAL [Cancidas] ![Compare how all Medicare Part D PDP plans in IA cover CASPOFUNGIN ACETATE 70 MG VIAL [Cancidas].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CAYSTON KIT 75 MG/VIAL ![Compare how all Medicare Part D PDP plans in IA cover CAYSTON KIT 75 MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CEFADROXIL 250 MG/5 ML ORAL SUSPENSION [Duricef] ![Compare how all Medicare Part D PDP plans in IA cover CEFADROXIL 250 MG/5 ML ORAL SUSPENSION [Duricef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFADROXIL 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CEFADROXIL 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CEFADROXIL 500 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CEFADROXIL 500 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFAZOLIN 1 GM VIAL [Kefzol] ![Compare how all Medicare Part D PDP plans in IA cover CEFAZOLIN 1 GM VIAL [Kefzol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFAZOLIN 10 GM VIAL [Kefzol] ![Compare how all Medicare Part D PDP plans in IA cover CEFAZOLIN 10 GM VIAL [Kefzol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFAZOLIN 500 MG VIAL [Ancef] ![Compare how all Medicare Part D PDP plans in IA cover CEFAZOLIN 500 MG VIAL [Ancef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFDINIR 125 MG/5 ML ORAL SUSPENSION [Omnicef] ![Compare how all Medicare Part D PDP plans in IA cover CEFDINIR 125 MG/5 ML ORAL SUSPENSION [Omnicef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFDINIR 250 MG/5 ML ORAL SUSPENSION [Omnicef] ![Compare how all Medicare Part D PDP plans in IA cover CEFDINIR 250 MG/5 ML ORAL SUSPENSION [Omnicef].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFDINIR 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CEFDINIR 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CEFEPIME HCL 1 GM VIAL [Maxipime] ![Compare how all Medicare Part D PDP plans in IA cover CEFEPIME HCL 1 GM VIAL [Maxipime].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFEPIME HCL 2 GRAM VIAL [Maxipime] ![Compare how all Medicare Part D PDP plans in IA cover CEFEPIME HCL 2 GRAM VIAL [Maxipime].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFIXIME 400 MG CAPSULE [Suprax] ![Compare how all Medicare Part D PDP plans in IA cover CEFIXIME 400 MG CAPSULE [Suprax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFOXITIN 1 GM VIAL [Mefoxin] ![Compare how all Medicare Part D PDP plans in IA cover CEFOXITIN 1 GM VIAL [Mefoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFOXITIN 2 GM VIAL [Mefoxin] ![Compare how all Medicare Part D PDP plans in IA cover CEFOXITIN 2 GM VIAL [Mefoxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFPODOXIME 100 MG TABLET [Vantin] ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 100 MG TABLET [Vantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFPODOXIME 100 MG/5 ML ORAL SUSPENSION [Vantin] ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 100 MG/5 ML ORAL SUSPENSION [Vantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFPODOXIME 200 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFPODOXIME 50 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CEFPODOXIME 50 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFPROZIL 125 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CEFPROZIL 125 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFPROZIL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CEFPROZIL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFPROZIL 250 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CEFPROZIL 250 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEFPROZIL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CEFPROZIL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTAZIDIME 1 GM VIAL [Tazidime] ![Compare how all Medicare Part D PDP plans in IA cover CEFTAZIDIME 1 GM VIAL [Tazidime].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN ![Compare how all Medicare Part D PDP plans in IA cover CEFTAZIDIME FOR INJECTION 2GM/VIAL 10 X 2 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN ![Compare how all Medicare Part D PDP plans in IA cover CEFTAZIDIME FOR INJECTION 6GM/VIAL 6 X 6 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTRIAXONE 1 GM VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 1 GM VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTRIAXONE 10 GM VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 10 GM VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTRIAXONE 2 GM VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 2 GM VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTRIAXONE 250 MG VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 250 MG VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFTRIAXONE 500 MG VIAL [Rocephin] ![Compare how all Medicare Part D PDP plans in IA cover CEFTRIAXONE 500 MG VIAL [Rocephin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEFUROXIME 1.5 GM/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME 1.5 GM/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFUROXIME 750 MG FOR INJECTION ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME 750 MG FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CEFUROXIME AXETIL 250 MG TABLET [Ceftin] ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME AXETIL 250 MG TABLET [Ceftin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CEFUROXIME AXETIL 500 MG TABLET [Ceftin] ![Compare how all Medicare Part D PDP plans in IA cover CEFUROXIME AXETIL 500 MG TABLET [Ceftin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CELECOXIB 100 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in IA cover CELECOXIB 100 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CELECOXIB 200 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in IA cover CELECOXIB 200 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CELECOXIB 400 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in IA cover CELECOXIB 400 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CELECOXIB 50 MG CAPSULE [Celebrex] ![Compare how all Medicare Part D PDP plans in IA cover CELECOXIB 50 MG CAPSULE [Celebrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION [Keflex] ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION [Keflex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CEPHALEXIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION [Keflex] ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION [Keflex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CEPHALEXIN 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CEPHALEXIN 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CERDELGA 84 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CERDELGA 84 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CETIRIZINE HCL 1 MG/ML SOLUTION [Zyrtec Syrup] ![Compare how all Medicare Part D PDP plans in IA cover CETIRIZINE HCL 1 MG/ML SOLUTION [Zyrtec Syrup].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CEVIMELINE HCL 30 MG CAPSULE [Evoxac] ![Compare how all Medicare Part D PDP plans in IA cover CEVIMELINE HCL 30 MG CAPSULE [Evoxac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CHLORDIAZEPOXIDE 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days |
CHLORDIAZEPOXIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:120 /30Days |
CHLORDIAZEPOXIDE 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CHLORDIAZEPOXIDE 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days |
CHLORHEXIDINE GLUCONATE 0.12% RINSE ![Compare how all Medicare Part D PDP plans in IA cover CHLORHEXIDINE GLUCONATE 0.12% RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CHLOROQUINE PH 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLOROQUINE PH 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CHLOROQUINE PH 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLOROQUINE PH 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CHLORPROMAZINE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHLORPROMAZINE 100 MG TABLET [Thorazine] ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 100 MG TABLET [Thorazine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CHLORPROMAZINE 100 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 100 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CHLORPROMAZINE 200 MG TABLET [Thorazine] ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 200 MG TABLET [Thorazine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CHLORPROMAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CHLORPROMAZINE 30 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 30 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CHLORPROMAZINE 50 MG TABLET [Thorazine] ![Compare how all Medicare Part D PDP plans in IA cover CHLORPROMAZINE 50 MG TABLET [Thorazine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CHLORTHALIDONE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORTHALIDONE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CHLORTHALIDONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CHLORTHALIDONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CHLORZOXAZONE 500 MG TABLET [Relax-DS] ![Compare how all Medicare Part D PDP plans in IA cover CHLORZOXAZONE 500 MG TABLET [Relax-DS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CHOLBAM 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CHOLBAM 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CHOLBAM 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CHOLBAM 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CHOLESTYRAMINE LIGHT POWDER PACKET [Questran Light] ![Compare how all Medicare Part D PDP plans in IA cover CHOLESTYRAMINE LIGHT POWDER PACKET [Questran Light].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CHOLESTYRAMINE PACKET ![Compare how all Medicare Part D PDP plans in IA cover CHOLESTYRAMINE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CICLOPIROX 0.77% CREAM (G) [Loprox] ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX 0.77% CREAM (G) [Loprox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CICLOPIROX 0.77% GEL ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX 0.77% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CICLOPIROX 0.77% TOPICAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX 0.77% TOPICAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:60 /30Days |
CICLOPIROX 1% SHAMPOO [Loprox] ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX 1% SHAMPOO [Loprox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CICLOPIROX 8% SOLUTION [Penlac] ![Compare how all Medicare Part D PDP plans in IA cover CICLOPIROX 8% SOLUTION [Penlac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
Cilastatin 250 MG / Imipenem 250 MG Injection ![Compare how all Medicare Part D PDP plans in IA cover Cilastatin 250 MG / Imipenem 250 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Cilastatin 500 MG / Imipenem 500 MG Injection ![Compare how all Medicare Part D PDP plans in IA cover Cilastatin 500 MG / Imipenem 500 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CILOSTAZOL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CILOSTAZOL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CILOSTAZOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CILOSTAZOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIMDUO 300-300 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CIMDUO 300-300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Cimetidine 200mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Cimetidine 200mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CIMETIDINE 300 MG TABLET [Tagamet] ![Compare how all Medicare Part D PDP plans in IA cover CIMETIDINE 300 MG TABLET [Tagamet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CIMETIDINE 400 MG TABLET [Tagamet] ![Compare how all Medicare Part D PDP plans in IA cover CIMETIDINE 400 MG TABLET [Tagamet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Cimetidine 800mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in IA cover Cimetidine 800mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Cimzia 2 KIT per CARTON / 1 KIT in 1 KIT ![Compare how all Medicare Part D PDP plans in IA cover Cimzia 2 KIT per CARTON / 1 KIT in 1 KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CIMZIA 200 MG/ML SYRINGE KIT ![Compare how all Medicare Part D PDP plans in IA cover CIMZIA 200 MG/ML SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CINACALCET HCL 30 MG TABLET [Sensipar] ![Compare how all Medicare Part D PDP plans in IA cover CINACALCET HCL 30 MG TABLET [Sensipar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CINACALCET HCL 60 MG TABLET [Sensipar] ![Compare how all Medicare Part D PDP plans in IA cover CINACALCET HCL 60 MG TABLET [Sensipar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CINACALCET HCL 90 MG TABLET [Sensipar] ![Compare how all Medicare Part D PDP plans in IA cover CINACALCET HCL 90 MG TABLET [Sensipar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
CINRYZE 500 UNIT VIAL-DILUENT ![Compare how all Medicare Part D PDP plans in IA cover CINRYZE 500 UNIT VIAL-DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CIPRO HC OTIC SUSPENSION EYE DROPPER ![Compare how all Medicare Part D PDP plans in IA cover CIPRO HC OTIC SUSPENSION EYE DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CIPROFLOX-DEXAMETH OTIC SUSPENSION EYE DROPPER [Ciprodex Otic] ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOX-DEXAMETH OTIC SUSPENSION EYE DROPPER [Ciprodex Otic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CIPROFLOXACIN 0.3% EYE DROPS [Ciloxan] ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN 0.3% EYE DROPS [Ciloxan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN 200 MG/100ML-D5W PIGGYBACK [Cipro] ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN 200 MG/100ML-D5W PIGGYBACK [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CIPROFLOXACIN HCL 250 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN HCL 250 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN HCL 500 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN HCL 500 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CIPROFLOXACIN HCL 750 MG TABLET [Cipro] ![Compare how all Medicare Part D PDP plans in IA cover CIPROFLOXACIN HCL 750 MG TABLET [Cipro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CITALOPRAM HBR 10 MG TABLET [Celexa] ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HBR 10 MG TABLET [Celexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CITALOPRAM HBR 10 MG/5 ML SOLUTION [Celexa] ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HBR 10 MG/5 ML SOLUTION [Celexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CITALOPRAM HBR 20 MG TABLET [Celexa] ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HBR 20 MG TABLET [Celexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CITALOPRAM HBR 40 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CITALOPRAM HBR 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLARAVIS 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLARAVIS 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLARAVIS 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLARAVIS 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Claravis 30mg 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IA cover Claravis 30mg 3 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLARAVIS 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CLARAVIS 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CLARITHROMYCIN 125 MG/5ML FOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLARITHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CLARITHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover CLARITHROMYCIN 250 MG/5MLFOR ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLARITHROMYCIN 500 MG TABLET [Biaxin] ![Compare how all Medicare Part D PDP plans in IA cover CLARITHROMYCIN 500 MG TABLET [Biaxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLEOCIN 100 MG VAGINAL OVULE SUPP.VAG ![Compare how all Medicare Part D PDP plans in IA cover CLEOCIN 100 MG VAGINAL OVULE SUPP.VAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLIMARA PRO DIS WEEKLY 4.40MG/1.39MG ![Compare how all Medicare Part D PDP plans in IA cover CLIMARA PRO DIS WEEKLY 4.40MG/1.39MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLIND PH-BENZOYL PEROX 1.2-5% [Benzaclin] ![Compare how all Medicare Part D PDP plans in IA cover CLIND PH-BENZOYL PEROX 1.2-5% [Benzaclin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN 2% VAGINAL CREAM w/APPL [Clindesse] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN 2% VAGINAL CREAM w/APPL [Clindesse].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINDAMYCIN HCL 150 MG CAPSULE [Cleocin] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN HCL 150 MG CAPSULE [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLINDAMYCIN HCL 300 MG CAPSULE [Cleocin] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN HCL 300 MG CAPSULE [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLINDAMYCIN HCL 75 MG CAPSULE [Cleocin] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN HCL 75 MG CAPSULE [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLINDAMYCIN PEDIATR 75 MG/5 ML SOLUTION RECON [Cleocin Pediatric] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PEDIATR 75 MG/5 ML SOLUTION RECON [Cleocin Pediatric].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINDAMYCIN PH 1% GEL [ClindaMax] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PH 1% GEL [ClindaMax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINDAMYCIN PH 1% SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PH 1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:60 /30Days |
CLINDAMYCIN PH 600 MG/4 ML VIAL [Cleocin] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PH 600 MG/4 ML VIAL [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINDAMYCIN PH 900 MG/6 ML VIAL [Cleocin] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PH 900 MG/6 ML VIAL [Cleocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINDAMYCIN PHOSP 1% LOTION [ClindaMax] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PHOSP 1% LOTION [ClindaMax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN PHOSPHATE TOPICAL SOLUTION USP PLEDGETS 1% 60 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLINDAMYCIN-BENZOYL PEROX 1-5% GEL [BenzaClin] ![Compare how all Medicare Part D PDP plans in IA cover CLINDAMYCIN-BENZOYL PEROX 1-5% GEL [BenzaClin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLINISOL 15% SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CLINISOL 15% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CLOBAZAM 10 MG TABLET [ONFI] ![Compare how all Medicare Part D PDP plans in IA cover CLOBAZAM 10 MG TABLET [ONFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:120 /30Days |
CLOBAZAM 2.5 MG/ML ORAL SUSPENSION [ONFI] ![Compare how all Medicare Part D PDP plans in IA cover CLOBAZAM 2.5 MG/ML ORAL SUSPENSION [ONFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:480 /30Days |
CLOBAZAM 20 MG TABLET [ONFI] ![Compare how all Medicare Part D PDP plans in IA cover CLOBAZAM 20 MG TABLET [ONFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:60 /30Days |
CLOBETASOL 0.05% CREAM (g) [Temovate] ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL 0.05% CREAM (g) [Temovate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLOBETASOL 0.05% GEL [Temovate] ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL 0.05% GEL [Temovate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLOBETASOL 0.05% OINTMENT [Temovate E] ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL 0.05% OINTMENT [Temovate E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLOBETASOL 0.05% SOLUTION [Temovate Scalp] ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL 0.05% SOLUTION [Temovate Scalp].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLOBETASOL EMOLLIENT 0.05% CREAM (G) [Temovate E] ![Compare how all Medicare Part D PDP plans in IA cover CLOBETASOL EMOLLIENT 0.05% CREAM (G) [Temovate E].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLOMIPRAMINE 25 MG CAPSULE [Anafranil] ![Compare how all Medicare Part D PDP plans in IA cover CLOMIPRAMINE 25 MG CAPSULE [Anafranil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOMIPRAMINE 50 MG CAPSULE [Anafranil] ![Compare how all Medicare Part D PDP plans in IA cover CLOMIPRAMINE 50 MG CAPSULE [Anafranil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLOMIPRAMINE 75 MG CAPSULE [Anafranil] ![Compare how all Medicare Part D PDP plans in IA cover CLOMIPRAMINE 75 MG CAPSULE [Anafranil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLONAZEPAM 0.125 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 0.125 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
CLONAZEPAM 0.25 MG ODT TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 0.25 MG ODT TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
CLONAZEPAM 0.5 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 0.5 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days |
CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:120 /30Days |
CLONAZEPAM 1 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 1 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:120 /30Days |
CLONAZEPAM 2 MG ODT TABLET RAPDIS [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 2 MG ODT TABLET RAPDIS [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:300 /30Days |
CLONAZEPAM 2 MG TABLET [Klonopin] ![Compare how all Medicare Part D PDP plans in IA cover CLONAZEPAM 2 MG TABLET [Klonopin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:300 /30Days |
CLONIDINE 0.1 MG/DAY PATCH [Catapres-TTS] ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE 0.1 MG/DAY PATCH [Catapres-TTS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLONIDINE 0.2 MG/DAY PATCH [Catapres-TTS] ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE 0.2 MG/DAY PATCH [Catapres-TTS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLONIDINE 0.3 MG/DAY PATCH [Catapres-TTS] ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE 0.3 MG/DAY PATCH [Catapres-TTS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CLONIDINE HCL 0.1 MG TABLET [Catapres] ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL 0.1 MG TABLET [Catapres].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLONIDINE HCL 0.2 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL 0.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLONIDINE HCL 0.3 MG TABLET [Catapres] ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL 0.3 MG TABLET [Catapres].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLONIDINE HCL ER 0.1 MG TABLET ER 12H [Kapvay] ![Compare how all Medicare Part D PDP plans in IA cover CLONIDINE HCL ER 0.1 MG TABLET ER 12H [Kapvay].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:4 /1Days |
CLOPIDOGREL 75 MG TABLET [Plavix] ![Compare how all Medicare Part D PDP plans in IA cover CLOPIDOGREL 75 MG TABLET [Plavix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CLORAZEPATE 15 MG TABLET [Tranxene] ![Compare how all Medicare Part D PDP plans in IA cover CLORAZEPATE 15 MG TABLET [Tranxene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:180 /30Days |
CLORAZEPATE 3.75 MG TABLET [Tranxene] ![Compare how all Medicare Part D PDP plans in IA cover CLORAZEPATE 3.75 MG TABLET [Tranxene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:180 /30Days |
CLORAZEPATE 7.5 MG TABLET [Tranxene T-Tab] ![Compare how all Medicare Part D PDP plans in IA cover CLORAZEPATE 7.5 MG TABLET [Tranxene T-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | Q:180 /30Days |
CLOTRIMAZOLE 1% SOLUTION [Lotrimin AF] ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE 1% SOLUTION [Lotrimin AF].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOTRIMAZOLE 1% TOPICAL CREAM (G) [Mycozyl AC] ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE 1% TOPICAL CREAM (G) [Mycozyl AC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CLOTRIMAZOLE 10 MG TROCHE [Mycelex Troche] ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE 10 MG TROCHE [Mycelex Troche].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLOTRIMAZOLE-BETAMETHASONE CREAM (G) [Lotrisone] ![Compare how all Medicare Part D PDP plans in IA cover CLOTRIMAZOLE-BETAMETHASONE CREAM (G) [Lotrisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CLOZAPINE 100 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 100 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLOZAPINE 200 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 200 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLOZAPINE 25 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 25 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLOZAPINE 50 MG TABLET [Clozaril] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE 50 MG TABLET [Clozaril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CLOZAPINE ODT 100 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE ODT 100 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CLOZAPINE ODT 12.5 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE ODT 12.5 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CLOZAPINE ODT 150 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE ODT 150 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CLOZAPINE ODT 200 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE ODT 200 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CLOZAPINE ODT 25 MG TABLET RAPDIS [Fazaclo] ![Compare how all Medicare Part D PDP plans in IA cover CLOZAPINE ODT 25 MG TABLET RAPDIS [Fazaclo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
COARTEM 20MG-120MG ![Compare how all Medicare Part D PDP plans in IA cover COARTEM 20MG-120MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CODEINE SULFATE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CODEINE SULFATE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:8 /1Days |
CODEINE SULFATE 30 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CODEINE SULFATE 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:8 /1Days |
CODEINE SULFATE 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CODEINE SULFATE 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:8 /1Days |
COLCHICINE 0.6 MG CAPSULE [MITIGARE] ![Compare how all Medicare Part D PDP plans in IA cover COLCHICINE 0.6 MG CAPSULE [MITIGARE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
COLCHICINE 0.6 MG TABLET [Colcrys] ![Compare how all Medicare Part D PDP plans in IA cover COLCHICINE 0.6 MG TABLET [Colcrys].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
COLESEVELAM 625 MG TABLET [WelChol] ![Compare how all Medicare Part D PDP plans in IA cover COLESEVELAM 625 MG TABLET [WelChol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
COLESTIPOL HCL 1 GM TABLET [Colestid] ![Compare how all Medicare Part D PDP plans in IA cover COLESTIPOL HCL 1 GM TABLET [Colestid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
COLISTIMETHATE 150 MG VIAL [Coly-Mycin M] ![Compare how all Medicare Part D PDP plans in IA cover COLISTIMETHATE 150 MG VIAL [Coly-Mycin M].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COMBIPATCH 0.05-0.14 MG PATCH ![Compare how all Medicare Part D PDP plans in IA cover COMBIPATCH 0.05-0.14 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
COMBIPATCH 0.05-0.25 MG PATCH ![Compare how all Medicare Part D PDP plans in IA cover COMBIPATCH 0.05-0.25 MG PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
COMBIVENT RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in IA cover COMBIVENT RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
COMETRIQ 100 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in IA cover COMETRIQ 100 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COMETRIQ 140 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in IA cover COMETRIQ 140 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COMETRIQ 60 MG DAILY-DOSE PACK ![Compare how all Medicare Part D PDP plans in IA cover COMETRIQ 60 MG DAILY-DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in IA cover COMPLERA 200; 27.5; 300mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
COMPRO 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in IA cover COMPRO 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CONSTULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CONSTULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
COPIKTRA 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover COPIKTRA 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COPIKTRA 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover COPIKTRA 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CORLANOR 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CORLANOR 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CORLANOR 5 MG/5 ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover CORLANOR 5 MG/5 ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CORLANOR 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover CORLANOR 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
COSENTYX 300 MG DOSE-2 PENS ![Compare how all Medicare Part D PDP plans in IA cover COSENTYX 300 MG DOSE-2 PENS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COSENTYX 300 MG DOSE-2 SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover COSENTYX 300 MG DOSE-2 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COSENTYX 75 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in IA cover COSENTYX 75 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COSENTYX UNOREADY 300 MG PEN INJCTR ![Compare how all Medicare Part D PDP plans in IA cover COSENTYX UNOREADY 300 MG PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
COTELLIC 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover COTELLIC 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover Creon 256.11mg/1 1 BOTTLE per CARTON / 70 CAPSULE, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CREON DELAYED RELEASE CAPSULES 12000MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover CREON DELAYED RELEASE CAPSULES 12000MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CREON DELAYED RELEASE CAPSULES 24000MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover CREON DELAYED RELEASE CAPSULES 24000MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CREON DELAYED RELEASE CAPSULES 6000MG 100 BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover CREON DELAYED RELEASE CAPSULES 6000MG 100 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CREON DR 36,000 UNITS CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CREON DR 36,000 UNITS CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CRESEMBA 186 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CRESEMBA 186 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CRESEMBA 74.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CRESEMBA 74.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom] ![Compare how all Medicare Part D PDP plans in IA cover CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CROMOLYN SODIUM 4% 40MG 10ML BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover CROMOLYN SODIUM 4% 40MG 10ML BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
CYCLOBENZAPRINE 10 MG TABLET [Flexeril] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOBENZAPRINE 10 MG TABLET [Flexeril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CYCLOBENZAPRINE 5 MG TABLET [Flexeril] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOBENZAPRINE 5 MG TABLET [Flexeril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CYCLOPHOSPHAMIDE 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOPHOSPHAMIDE 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P |
CYCLOPHOSPHAMIDE 25 MG TABLET [Cytoxan] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOPHOSPHAMIDE 25 MG TABLET [Cytoxan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOPHOSPHAMIDE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOPHOSPHAMIDE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOPHOSPHAMIDE 50 MG TABLET [Cytoxan] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOPHOSPHAMIDE 50 MG TABLET [Cytoxan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYCLOSERINE 250 MG CAPSULE [Seromycin] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSERINE 250 MG CAPSULE [Seromycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
CYCLOSPORINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOSPORINE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOSPORINE MODIFIED 100 MG CAPSULE [Neoral] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE MODIFIED 100 MG CAPSULE [Neoral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOSPORINE MODIFIED 25 MG CAPSULE [Neoral] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE MODIFIED 25 MG CAPSULE [Neoral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOSPORINE MODIFIED 50 MG CAPSULE [Neoral] ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE MODIFIED 50 MG CAPSULE [Neoral].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOTTLE ![Compare how all Medicare Part D PDP plans in IA cover CYCLOSPORINE ORAL SOLUTION 100MG 50ML BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | P |
CYPROHEPTADINE 4 MG TABLET [Periactin] ![Compare how all Medicare Part D PDP plans in IA cover CYPROHEPTADINE 4 MG TABLET [Periactin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL ![Compare how all Medicare Part D PDP plans in IA cover CYPROHEPTADINE HYDROCHLORIDE SOLUTION USP SYRUP 2MG 473 ML BOTGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
CYRED EQ 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in IA cover CYRED EQ 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
CYSTADROPS 0.37% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover CYSTADROPS 0.37% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
CYSTAGON 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYSTAGON 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CYSTAGON 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover CYSTAGON 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $250.00 | None |
CYSTARAN 0.44% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover CYSTARAN 0.44% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |