2024 Medicare Part D Plan Formulary Information |
Anthem Medicare Advantage (PPO) (H4036-036-0)
Benefits & Contact Info
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (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 Anthem Medicare Advantage (PPO) (H4036-036-0) Formulary Drugs Starting with the Letter B in Fulton County, KY: CMS MA Region 13 which includes: KY
|
Drugs Starting with Letter B
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Bacitracin 500 unit/gm Eye Ointment ![Compare how all Medicare Part D PDP plans in KY cover Bacitracin 500 unit/gm Eye Ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT ![Compare how all Medicare Part D PDP plans in KY cover BACITRACIN/POLYMYXIN B OINT 500UNT/10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BACLOFEN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BACLOFEN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:90 /30Days |
BACLOFEN 20 MG TABLET [Lioresal] ![Compare how all Medicare Part D PDP plans in KY cover BACLOFEN 20 MG TABLET [Lioresal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:120 /30Days |
BACLOFEN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BACLOFEN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:90 /30Days |
BALSALAZIDE DISODIUM 750 MG CAPSULE [Colazal] ![Compare how all Medicare Part D PDP plans in KY cover BALSALAZIDE DISODIUM 750 MG CAPSULE [Colazal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BALVERSA 3 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BALVERSA 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
BALVERSA 4 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BALVERSA 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
BALVERSA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BALVERSA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
Balziva 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in KY cover Balziva 6 POUCH per CARTON / 1 BLISTER PACK in 1 POUCH / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in KY cover BARACLUDE 0.05mg/mL 1 BOTTLE per CARTON / 210 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
BCG VACCINE 50mg/1 1 VIAL per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in KY cover BCG VACCINE 50mg/1 1 VIAL per CARTON / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BELSOMRA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BELSOMRA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:30 /30Days |
BELSOMRA 15 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BELSOMRA 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:30 /30Days |
BELSOMRA 20 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BELSOMRA 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:30 /30Days |
BELSOMRA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BELSOMRA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:30 /30Days |
BENAZEPRIL HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENAZEPRIL HCL 20 MG TABLET [Lotensin] ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL HCL 20 MG TABLET [Lotensin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENAZEPRIL HCL 40 MG TABLET [Lotensin] ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL HCL 40 MG TABLET [Lotensin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENAZEPRIL HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENAZEPRIL-HCTZ 10-12.5 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL-HCTZ 10-12.5 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BENAZEPRIL-HCTZ 20-12.5 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL-HCTZ 20-12.5 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENAZEPRIL-HCTZ 20-25 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL-HCTZ 20-25 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENAZEPRIL-HCTZ 5-6.25 MG TABLET [Lotensin HCT] ![Compare how all Medicare Part D PDP plans in KY cover BENAZEPRIL-HCTZ 5-6.25 MG TABLET [Lotensin HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6 |
Tier 6 |
$0.00 | $0.00 | None |
BENLYSTA 200 MG/ML AUTOINJECT ![Compare how all Medicare Part D PDP plans in KY cover BENLYSTA 200 MG/ML AUTOINJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
BENLYSTA 200 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in KY cover BENLYSTA 200 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
BENZTROPINE MES 0.5 MG TABLET [Cogentin] ![Compare how all Medicare Part D PDP plans in KY cover BENZTROPINE MES 0.5 MG TABLET [Cogentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | P |
BENZTROPINE MES 1 MG TABLET [Cogentin] ![Compare how all Medicare Part D PDP plans in KY cover BENZTROPINE MES 1 MG TABLET [Cogentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | P |
BENZTROPINE MES 2 MG TABLET [Cogentin] ![Compare how all Medicare Part D PDP plans in KY cover BENZTROPINE MES 2 MG TABLET [Cogentin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | P |
BEPOTASTINE 1.5% EYE DROPS [Bepreve] ![Compare how all Medicare Part D PDP plans in KY cover BEPOTASTINE 1.5% EYE DROPS [Bepreve].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BESREMI 500 MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in KY cover BESREMI 500 MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
BETAINE 1 GRAM/SCOOP POWDER [Cystadane] ![Compare how all Medicare Part D PDP plans in KY cover BETAINE 1 GRAM/SCOOP POWDER [Cystadane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Betamethasone Dipropionate 0.64mg/g / 45 g TUBE ![Compare how all Medicare Part D PDP plans in KY cover Betamethasone Dipropionate 0.64mg/g / 45 g TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETAMETHASONE DP 0.05% LOTION ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE DP 0.05% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BETAMETHASONE DP 0.05% OINTMENT [Maxivate] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE DP 0.05% OINTMENT [Maxivate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETAMETHASONE DP AUG 0.05% CREAM (g) [RRB Pak] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE DP AUG 0.05% CREAM (g) [RRB Pak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BETAMETHASONE DP AUG 0.05% GEL ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE DP AUG 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETAMETHASONE DP AUG 0.05% LOTION [Diprolene] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE DP AUG 0.05% LOTION [Diprolene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETAMETHASONE DP AUG 0.05% OINTMENT [Diprolene] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE DP AUG 0.05% OINTMENT [Diprolene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETAMETHASONE VA 0.1% CREAM (G) [Valisone] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE VA 0.1% CREAM (G) [Valisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BETAMETHASONE VALER 0.1% LOTION [Valisone] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE VALER 0.1% LOTION [Valisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETAMETHASONE VALER 0.1% OINTMENT [Valisone] ![Compare how all Medicare Part D PDP plans in KY cover BETAMETHASONE VALER 0.1% OINTMENT [Valisone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BETASERON 0.3 MG KIT ![Compare how all Medicare Part D PDP plans in KY cover BETASERON 0.3 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:15 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BETAXOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BETAXOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BETAXOLOL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BETAXOLOL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BETAXOLOL HCL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in KY cover BETAXOLOL HCL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BETHANECHOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BETHANECHOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BETHANECHOL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BETHANECHOL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BETHANECHOL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BETHANECHOL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BETHANECHOL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BETHANECHOL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETIMOL 0.25% EYE DROPS ![Compare how all Medicare Part D PDP plans in KY cover BETIMOL 0.25% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETIMOL 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in KY cover BETIMOL 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BETOPTIC S 0.25% EYE DROP EYE DROPPER ![Compare how all Medicare Part D PDP plans in KY cover BETOPTIC S 0.25% EYE DROP EYE DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BEXAROTENE 1% GEL [Targretin] ![Compare how all Medicare Part D PDP plans in KY cover BEXAROTENE 1% GEL [Targretin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BEXAROTENE 75 MG CAPSULE [Targretin] ![Compare how all Medicare Part D PDP plans in KY cover BEXAROTENE 75 MG CAPSULE [Targretin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:300 /30Days |
BEXSERO PREFILLED SYRINGE ![Compare how all Medicare Part D PDP plans in KY cover BEXSERO PREFILLED SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BICALUTAMIDE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BICALUTAMIDE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30 /30Days |
BICILL LA PFS 600MU 1ML PED ![Compare how all Medicare Part D PDP plans in KY cover BICILL LA PFS 600MU 1ML PED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BICILLIN C-R 1.2MM UNITS SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in KY cover BICILLIN C-R 1.2MM UNITS SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BICILLIN C-R 900/300 SYRINGE 2ML x 10 ![Compare how all Medicare Part D PDP plans in KY cover BICILLIN C-R 900/300 SYRINGE 2ML x 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BICILLIN LA PFS 1200MU 2ML ![Compare how all Medicare Part D PDP plans in KY cover BICILLIN LA PFS 1200MU 2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BICILLIN LA. 600000UNIT/ML 1ML ![Compare how all Medicare Part D PDP plans in KY cover BICILLIN LA. 600000UNIT/ML 1ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BIJUVA 0.5 MG-100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BIJUVA 0.5 MG-100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | P |
BIJUVA 1 MG-100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BIJUVA 1 MG-100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | P |
BIKTARVY 30-120-15 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BIKTARVY 30-120-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BIKTARVY 50-200-25 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BIKTARVY 50-200-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:30 /30Days |
BIMATOPROST 0.03% EYE DROPS [Lumigan] ![Compare how all Medicare Part D PDP plans in KY cover BIMATOPROST 0.03% EYE DROPS [Lumigan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BISOPROLOL FUMARATE 10 MG TABLET [Zebeta] ![Compare how all Medicare Part D PDP plans in KY cover BISOPROLOL FUMARATE 10 MG TABLET [Zebeta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BISOPROLOL FUMARATE 5 MG TABLET [Zebeta] ![Compare how all Medicare Part D PDP plans in KY cover BISOPROLOL FUMARATE 5 MG TABLET [Zebeta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BISOPROLOL-HCTZ 10-6.25 MG TABLET [Ziac] ![Compare how all Medicare Part D PDP plans in KY cover BISOPROLOL-HCTZ 10-6.25 MG TABLET [Ziac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
BISOPROLOL-HCTZ 2.5-6.25 MG TABLET [Ziac] ![Compare how all Medicare Part D PDP plans in KY cover BISOPROLOL-HCTZ 2.5-6.25 MG TABLET [Ziac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
BISOPROLOL-HCTZ 5-6.25 MG TABLET [Ziac] ![Compare how all Medicare Part D PDP plans in KY cover BISOPROLOL-HCTZ 5-6.25 MG TABLET [Ziac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
BLISOVI 24 FE TABLET [Tarina Fe 1/20] ![Compare how all Medicare Part D PDP plans in KY cover BLISOVI 24 FE TABLET [Tarina Fe 1/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BLISOVI FE 1.5-30 TABLET [Microgestin Fe 1.5/30] ![Compare how all Medicare Part D PDP plans in KY cover BLISOVI FE 1.5-30 TABLET [Microgestin Fe 1.5/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BOOSTRIX TDAP VACCINE SYRINGE ![Compare how all Medicare Part D PDP plans in KY cover BOOSTRIX TDAP VACCINE SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BOOSTRIX TDAP VACCINE VIAL ![Compare how all Medicare Part D PDP plans in KY cover BOOSTRIX TDAP VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BOSENTAN 125 MG TABLET [Tracleer] ![Compare how all Medicare Part D PDP plans in KY cover BOSENTAN 125 MG TABLET [Tracleer].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
BOSENTAN 62.5 MG TABLET [Tracleer] ![Compare how all Medicare Part D PDP plans in KY cover BOSENTAN 62.5 MG TABLET [Tracleer].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
BOSULIF 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BOSULIF 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:120 /30Days |
BOSULIF 100 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BOSULIF 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:120 /30Days |
BOSULIF 400 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BOSULIF 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
BOSULIF 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BOSULIF 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
BOSULIF 500 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BOSULIF 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
BRAFTOVI 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BRAFTOVI 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:180 /30Days |
BREO ELLIPTA 100-25 MCG INH ![Compare how all Medicare Part D PDP plans in KY cover BREO ELLIPTA 100-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
BREO ELLIPTA 200-25 MCG INH ![Compare how all Medicare Part D PDP plans in KY cover BREO ELLIPTA 200-25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
BREO ELLIPTA 50-25 MCG INHALER BLST W/DEV ![Compare how all Medicare Part D PDP plans in KY cover BREO ELLIPTA 50-25 MCG INHALER BLST W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BREYNA 160-4.5 MCG INHALER HFA AER AD [Symbicort] ![Compare how all Medicare Part D PDP plans in KY cover BREYNA 160-4.5 MCG INHALER HFA AER AD [Symbicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30.9 /30Days |
BREYNA 80-4.5 MCG INHALER HFA AER AD [Symbicort] ![Compare how all Medicare Part D PDP plans in KY cover BREYNA 80-4.5 MCG INHALER HFA AER AD [Symbicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30.9 /30Days |
BREZTRI AEROSPHERE INHALER HFA AER AD ![Compare how all Medicare Part D PDP plans in KY cover BREZTRI AEROSPHERE INHALER HFA AER AD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:10.7 /30Days |
BRIELLYN TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRIELLYN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BRILINTA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRILINTA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
BRILINTA 90mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in KY cover BRILINTA 90mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days |
BRIMONIDINE 0.2% EYE DROPS [Alphagan] ![Compare how all Medicare Part D PDP plans in KY cover BRIMONIDINE 0.2% EYE DROPS [Alphagan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BRIMONIDINE TARTRATE 0.15% DROPS [Alphagan P] ![Compare how all Medicare Part D PDP plans in KY cover BRIMONIDINE TARTRATE 0.15% DROPS [Alphagan P].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BRIMONIDINE-TIMOLOL 0.2%-0.5% DROPS [Combigan] ![Compare how all Medicare Part D PDP plans in KY cover BRIMONIDINE-TIMOLOL 0.2%-0.5% DROPS [Combigan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BRINZOLAMIDE 1% EYE DROPS/EYE DROPPER [Azopt] ![Compare how all Medicare Part D PDP plans in KY cover BRINZOLAMIDE 1% EYE DROPS/EYE DROPPER [Azopt].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BRIVIACT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRIVIACT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BRIVIACT 10 MG/ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in KY cover BRIVIACT 10 MG/ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:600 /30Days |
BRIVIACT 100 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRIVIACT 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:60 /30Days |
BRIVIACT 25 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRIVIACT 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:60 /30Days |
BRIVIACT 50 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRIVIACT 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:60 /30Days |
BRIVIACT 75 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BRIVIACT 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | Q:60 /30Days |
BROMFENAC SODIUM 0.07% EYE DROPS [Prolensa] ![Compare how all Medicare Part D PDP plans in KY cover BROMFENAC SODIUM 0.07% EYE DROPS [Prolensa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom] ![Compare how all Medicare Part D PDP plans in KY cover BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BROMOCRIPTINE 2.5 MG TABLET [Parlodel] ![Compare how all Medicare Part D PDP plans in KY cover BROMOCRIPTINE 2.5 MG TABLET [Parlodel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BROMOCRIPTINE 5 MG CAPSULE [Parlodel] ![Compare how all Medicare Part D PDP plans in KY cover BROMOCRIPTINE 5 MG CAPSULE [Parlodel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BROMSITE 0.075% EYE DROPS ![Compare how all Medicare Part D PDP plans in KY cover BROMSITE 0.075% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BRONCHITOL 40 MG INHALE CAPSULE W/DEV ![Compare how all Medicare Part D PDP plans in KY cover BRONCHITOL 40 MG INHALE CAPSULE W/DEV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BRUKINSA 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BRUKINSA 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:120 /30Days |
BUDESONIDE 0.25 MG/2 ML SUSP AMPUL-NEB [Pulmicort] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE 0.25 MG/2 ML SUSP AMPUL-NEB [Pulmicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:120 /30Days |
BUDESONIDE 0.5 MG/2 ML SUSP AMPUL-NEB [Pulmicort] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE 0.5 MG/2 ML SUSP AMPUL-NEB [Pulmicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:120 /30Days |
BUDESONIDE 1 MG/2 ML INH SUSP AMPUL-NEB [Pulmicort] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE 1 MG/2 ML INH SUSP AMPUL-NEB [Pulmicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:60 /30Days |
BUDESONIDE EC 3 MG CAPSULE DR - ER [Entocort EC] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE EC 3 MG CAPSULE DR - ER [Entocort EC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BUDESONIDE ER 9 MG TABLET ER [UCERIS] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE ER 9 MG TABLET ER [UCERIS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
BUDESONIDE-FORMOTEROL 160-4.5 HFA AER AD [Symbicort] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE-FORMOTEROL 160-4.5 HFA AER AD [Symbicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30.6 /30Days |
BUDESONIDE-FORMOTEROL 80-4.5 HFA AER AD [Symbicort] ![Compare how all Medicare Part D PDP plans in KY cover BUDESONIDE-FORMOTEROL 80-4.5 HFA AER AD [Symbicort].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | Q:30.6 /30Days |
BUMETANIDE 0.5 MG TABLET [Bumex] ![Compare how all Medicare Part D PDP plans in KY cover BUMETANIDE 0.5 MG TABLET [Bumex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BUMETANIDE 1 MG TABLET [Bumex] ![Compare how all Medicare Part D PDP plans in KY cover BUMETANIDE 1 MG TABLET [Bumex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BUMETANIDE 1 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in KY cover BUMETANIDE 1 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUMETANIDE 2 MG TABLET [Bumex] ![Compare how all Medicare Part D PDP plans in KY cover BUMETANIDE 2 MG TABLET [Bumex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BUPRENORP-NALOX 12-3 MG SL FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORP-NALOX 12-3 MG SL FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:60 /30Days |
BUPRENORPHIN-NALOXON 8-2 MG SL SUSLIGUAL TABLET [Suboxone] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHIN-NALOXON 8-2 MG SL SUSLIGUAL TABLET [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:120 /30Days |
BUPRENORPHINE 10 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 10 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:4 /28Days |
BUPRENORPHINE 15 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 15 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:4 /28Days |
BUPRENORPHINE 2 MG TABLET SUBLIGUAL [Subutex] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 2 MG TABLET SUBLIGUAL [Subutex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:240 /30Days |
BUPRENORPHINE 20 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 20 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:4 /28Days |
BUPRENORPHINE 5 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 5 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:4 /28Days |
BUPRENORPHINE 7.5 MCG/HR PATCH [Butrans] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 7.5 MCG/HR PATCH [Butrans].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:4 /28Days |
BUPRENORPHINE 8 MG TABLET SUSLIGUAL [Subutex] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE 8 MG TABLET SUSLIGUAL [Subutex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:60 /30Days |
BUPRENORPHINE-NALOX 2-0.5MG FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE-NALOX 2-0.5MG FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:480 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUPRENORPHINE-NALOX 4-1MG FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE-NALOX 4-1MG FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:240 /30Days |
BUPRENORPHINE-NALOX 8-2MG FILM [Suboxone] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHINE-NALOX 8-2MG FILM [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:120 /30Days |
BUPRENORPHN-NALOXN 2-0.5 MG TABLET SUSLIGUAL [Suboxone] ![Compare how all Medicare Part D PDP plans in KY cover BUPRENORPHN-NALOXN 2-0.5 MG TABLET SUSLIGUAL [Suboxone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:480 /30Days |
BUPROPION HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:135 /30Days |
BUPROPION HCL 75 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:180 /30Days |
BUPROPION HCL SR 100 MG TABLET SR 12H [Wellbutrin SR] ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL SR 100 MG TABLET SR 12H [Wellbutrin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:120 /30Days |
BUPROPION HCL SR 150 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL SR 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:60 /30Days |
BUPROPION HCL SR 150 MG TABLET SR 12H [Wellbutrin SR] ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL SR 150 MG TABLET SR 12H [Wellbutrin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:60 /30Days |
BUPROPION HCL SR 200 MG TABLET SR 12H [Wellbutrin SR] ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL SR 200 MG TABLET SR 12H [Wellbutrin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:60 /30Days |
BUPROPION HCL XL 150 MG TABLET ER 24H [Wellbutrin XL] ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL XL 150 MG TABLET ER 24H [Wellbutrin XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:90 /30Days |
BUPROPION HCL XL 300 MG TABLET ER 24H [Wellbutrin XL] ![Compare how all Medicare Part D PDP plans in KY cover BUPROPION HCL XL 300 MG TABLET ER 24H [Wellbutrin XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUSPIRONE HCL 15 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUSPIRONE HCL 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BUSPIRONE HCL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUSPIRONE HCL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | None |
BUSPIRONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUSPIRONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BUSPIRONE HCL 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUSPIRONE HCL 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | None |
BUSPIRONE HYDROCHLORIDE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KY cover BUSPIRONE HYDROCHLORIDE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$12.00 | $0.00 | None |
BUTALB-ACETAMIN-CAFF 50-300-40 CAPSULE [Phrenilin Forte] ![Compare how all Medicare Part D PDP plans in KY cover BUTALB-ACETAMIN-CAFF 50-300-40 CAPSULE [Phrenilin Forte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:180 /30Days |
BUTALB-ACETAMIN-CAFF 50-325-40 TABLET [Repan] ![Compare how all Medicare Part D PDP plans in KY cover BUTALB-ACETAMIN-CAFF 50-325-40 TABLET [Repan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:180 /30Days |
BUTALB-CAFF-ACETAMINOPH-CODEIN ![Compare how all Medicare Part D PDP plans in KY cover BUTALB-CAFF-ACETAMINOPH-CODEIN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:180 /30Days |
BUTALBITAL-ACETAMINOPHN 50-325 TABLET [Phrenilin] ![Compare how all Medicare Part D PDP plans in KY cover BUTALBITAL-ACETAMINOPHN 50-325 TABLET [Phrenilin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:180 /30Days |
BUTALBITAL-ASA-CAFFEINE CAPSULE [Fiorinal] ![Compare how all Medicare Part D PDP plans in KY cover BUTALBITAL-ASA-CAFFEINE CAPSULE [Fiorinal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:180 /30Days |
BUTALBITAL/ACETAMINOPHEN/CAFFEINE CAPSULE ![Compare how all Medicare Part D PDP plans in KY cover BUTALBITAL/ACETAMINOPHEN/CAFFEINE CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
BUTORPHANOL 10 MG/ML SPRAY [Stadol NS] ![Compare how all Medicare Part D PDP plans in KY cover BUTORPHANOL 10 MG/ML SPRAY [Stadol NS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:5 /30Days |
BYDUREON BCISE 2 MG AUTOINJECT ![Compare how all Medicare Part D PDP plans in KY cover BYDUREON BCISE 2 MG AUTOINJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | P Q:4 /28Days |
BYETTA 10 MCG DOSE PEN INJ ![Compare how all Medicare Part D PDP plans in KY cover BYETTA 10 MCG DOSE PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | P Q:2.4 /30Days |
BYETTA 5 MCG DOSE PEN INJ ![Compare how all Medicare Part D PDP plans in KY cover BYETTA 5 MCG DOSE PEN INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$42.00 | $84.00 | P Q:1.2 /30Days |