2025 Medicare Part D Plan Formulary Information |
AARP Medicare Rx Preferred from UHC (PDP) (S5921-387-0)
Benefits & Contact Info
 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 AARP Medicare Rx Preferred from UHC (PDP) (S5921-387-0) Formulary Drugs Starting with the Letter I in CMS PDP Region 5 which includes: DC DE MD
|
Drugs Starting with Letter I
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
IBANDRONATE SODIUM 150 MG TABLET [Boniva] ![Compare how all Medicare Part D PDP plans in DE cover IBANDRONATE SODIUM 150 MG TABLET [Boniva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:1 /28Days |
IBRANCE 100 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
IBRANCE 100 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
IBRANCE 125 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
IBRANCE 125 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
IBRANCE 75 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
IBRANCE 75 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
IBU 600 MG TABLET [Toxicology Saliva Collection] ![Compare how all Medicare Part D PDP plans in DE cover IBU 600 MG TABLET [Toxicology Saliva Collection].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IBU 800 MG TABLET [Samson-8] ![Compare how all Medicare Part D PDP plans in DE cover IBU 800 MG TABLET [Samson-8].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [PediaCare Children's Pain Reliever/Fever Reducer IB] ![Compare how all Medicare Part D PDP plans in DE cover IBUPROFEN 100 MG/5 ML ORAL SUSPENSION [PediaCare Children's Pain Reliever/Fever Reducer IB].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IBUPROFEN 400 MG TABLET [Motrin] ![Compare how all Medicare Part D PDP plans in DE cover IBUPROFEN 400 MG TABLET [Motrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IBUPROFEN 600 MG TABLET [Toxicology Saliva Collection] ![Compare how all Medicare Part D PDP plans in DE cover IBUPROFEN 600 MG TABLET [Toxicology Saliva Collection].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IBUPROFEN 800 MG TABLET [Samson-8] ![Compare how all Medicare Part D PDP plans in DE cover IBUPROFEN 800 MG TABLET [Samson-8].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ICATIBANT 30 MG/3 ML SYRINGE [FIRAZYR] ![Compare how all Medicare Part D PDP plans in DE cover ICATIBANT 30 MG/3 ML SYRINGE [FIRAZYR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:36 /30Days |
ICLEVIA 0.15 MG-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in DE cover ICLEVIA 0.15 MG-0.03 MG TABLET TBDSPK 3MO [Setlakin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
ICLUSIG 10 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
ICLUSIG 15 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
ICLUSIG 30 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
ICLUSIG 45 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
IDHIFA 100 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
IDHIFA 50 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMATINIB MESYLATE 100 MG TABLET [Gleevec] ![Compare how all Medicare Part D PDP plans in DE cover IMATINIB MESYLATE 100 MG TABLET [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:90 /30Days |
IMATINIB MESYLATE 400 MG TABLET [Gleevec] ![Compare how all Medicare Part D PDP plans in DE cover IMATINIB MESYLATE 400 MG TABLET [Gleevec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:90 /30Days |
IMBRUVICA 140 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
IMBRUVICA 140 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
IMBRUVICA 280 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
IMBRUVICA 420 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
IMBRUVICA 70 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
IMBRUVICA 70 MG/ML ORAL SUSPENSION  |
5 |
Specialty Tier |
33% | N/A | P Q:240 /30Days |
IMIPRAMINE HCL 10 MG TABLET [Tofranil] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE HCL 10 MG TABLET [Tofranil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
IMIPRAMINE HCL 25 MG TABLET [Tofranil] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE HCL 25 MG TABLET [Tofranil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
IMIPRAMINE HCL 50 MG TABLET [Tofranil] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE HCL 50 MG TABLET [Tofranil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IMIPRAMINE PAMOATE 100 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE PAMOATE 100 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
IMIPRAMINE PAMOATE 125 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE PAMOATE 125 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
IMIPRAMINE PAMOATE 150 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE PAMOATE 150 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
IMIPRAMINE PAMOATE 75 MG CAPSULE [Tofranil-PM] ![Compare how all Medicare Part D PDP plans in DE cover IMIPRAMINE PAMOATE 75 MG CAPSULE [Tofranil-PM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
IMIQUIMOD 5% CREAM PACKET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:24 /30Days |
IMOVAX RABIES VACCINE VIAL  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:1 /1Days |
IMPAVIDO 50 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | None |
IMVEXXY 10 MCG MAINTENANCE PAK INSERT  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:8 /28Days |
IMVEXXY 10 MCG STARTER PACK INSR DS PK  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:36 /365Days |
IMVEXXY 4 MCG MAINTENANCE PACK INSERT  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:8 /28Days |
IMVEXXY 4 MCG STARTER PACK INSR DS PK  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:36 /365Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INBRIJA 42 MG INHALATION CAPSULE W/DEV  |
5 |
Specialty Tier |
33% | N/A | P |
INCASSIA 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in DE cover INCASSIA 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE  |
5 |
Specialty Tier |
33% | N/A | P |
INCRUSE ELLIPTA 62.5 MCG INH  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:30 /30Days |
INDAPAMIDE 1.25 MG TABLET [Lozol] ![Compare how all Medicare Part D PDP plans in DE cover INDAPAMIDE 1.25 MG TABLET [Lozol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
INDAPAMIDE 2.5 MG TABLET [Lozol] ![Compare how all Medicare Part D PDP plans in DE cover INDAPAMIDE 2.5 MG TABLET [Lozol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
INDOMETHACIN 25 MG CAPSULE [Indocin] ![Compare how all Medicare Part D PDP plans in DE cover INDOMETHACIN 25 MG CAPSULE [Indocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
INDOMETHACIN 50 MG CAPSULE [Indocin] ![Compare how all Medicare Part D PDP plans in DE cover INDOMETHACIN 50 MG CAPSULE [Indocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
INDOMETHACIN ER 75 MG CAPSULE ER [Indocin SR] ![Compare how all Medicare Part D PDP plans in DE cover INDOMETHACIN ER 75 MG CAPSULE ER [Indocin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INFANRIX DTAP SYRINGE  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:0.50 /1Days |
INGREZZA 40 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INGREZZA 40 MG SPRINKLE CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
INGREZZA 60 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
INGREZZA 60 MG SPRINKLE CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
INGREZZA 80 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
INGREZZA 80 MG SPRINKLE CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
INGREZZA INITIATION PACK CAPSULE DS PK  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
INLYTA 1 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
INLYTA 5 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
INQOVI 35 MG-100 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:5 /28Days |
INREBIC 100 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
INSULIN ASPART 100 UNIT/ML CARTRIDGE  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INSULIN ASPART 100 UNIT/ML INSULIN PEN [NovoLog PenFill] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN ASPART 100 UNIT/ML INSULIN PEN [NovoLog PenFill].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN ASPART 100 UNIT/ML VIAL [NovoLog PenFill] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN ASPART 100 UNIT/ML VIAL [NovoLog PenFill].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN ASPART PROT-INSULN ASP INSULIN PEN [NovoLog Mix 70/30] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN ASPART PROT-INSULN ASP INSULIN PEN [NovoLog Mix 70/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN ASPART PROT-INSULN ASP VIAL [NovoLog Mix 70/30] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN ASPART PROT-INSULN ASP VIAL [NovoLog Mix 70/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN LISPRO 100 UNIT/ML INSULN PEN [LYUMJEV] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN LISPRO 100 UNIT/ML INSULN PEN [LYUMJEV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN LISPRO 100 UNIT/ML VIAL [LYUMJEV] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN LISPRO 100 UNIT/ML VIAL [LYUMJEV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN LISPRO JR 100 UNIT/ML INSULN PEN HF  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INSULIN LISPRO MIX 75-25 KWIKPEN INSULN PEN [Humalog KwikPen Mix 75/25] ![Compare how all Medicare Part D PDP plans in DE cover INSULIN LISPRO MIX 75-25 KWIKPEN INSULN PEN [Humalog KwikPen Mix 75/25].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
INTELENCE 25 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:120 /30Days |
INTRALIPID 20% IV FAT EMULSION [NUTRILIPID] ![Compare how all Medicare Part D PDP plans in DE cover INTRALIPID 20% IV FAT EMULSION [NUTRILIPID].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
INTRALIPID 30% IV FAT EMULSION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin] ![Compare how all Medicare Part D PDP plans in DE cover INTROVALE 0.15-0.03 MG TABLET TBDSPK 3MO [Setlakin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
INVEGA HAFYERA 1,092 MG/3.5 ML SYRINGE  |
5 |
Specialty Tier |
33% | N/A | None |
INVEGA HAFYERA 1,560 MG/5 ML SYRINGE  |
5 |
Specialty Tier |
33% | N/A | None |
Invega Sustenna 117 mg/0.75mL Prefilled Syringe  |
5 |
Specialty Tier |
33% | N/A | None |
Invega Sustenna 156 mg/mL Prefilled Syringe  |
5 |
Specialty Tier |
33% | N/A | None |
Invega Sustenna 234 mg/1.5mL Prefilled Syringe  |
5 |
Specialty Tier |
33% | N/A | None |
Invega Sustenna 39 mg/0.25mL Prefilled Syringe  |
4 |
Non-Preferred Drug |
40% | N/A | None |
Invega Sustenna 78 mg/0.5mL Prefilled Syringe  |
5 |
Specialty Tier |
33% | N/A | None |
INVEGA TRINZA 273 MG/0.875 ML  |
5 |
Specialty Tier |
33% | N/A | None |
INVEGA TRINZA 410 MG/1.315 ML  |
5 |
Specialty Tier |
33% | N/A | None |
INVEGA TRINZA 546 MG/1.75 ML  |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVEGA TRINZA 819 MG/2.625 ML  |
5 |
Specialty Tier |
33% | N/A | None |
IPOL VIAL 40;8;32; UNT  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:0.50 /1Days |
IPRAT-ALBUT 0.5-3(2.5) MG/3 ML AMPUL-NEB [DuoNeb] ![Compare how all Medicare Part D PDP plans in DE cover IPRAT-ALBUT 0.5-3(2.5) MG/3 ML AMPUL-NEB [DuoNeb].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | P |
IPRATROPIUM 0.03% SPRAY [Atrovent] ![Compare how all Medicare Part D PDP plans in DE cover IPRATROPIUM 0.03% SPRAY [Atrovent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
IPRATROPIUM 0.06% SPRAY [Atrovent] ![Compare how all Medicare Part D PDP plans in DE cover IPRATROPIUM 0.06% SPRAY [Atrovent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
IPRATROPIUM BR 0.02% SOLUTION [Atrovent] ![Compare how all Medicare Part D PDP plans in DE cover IPRATROPIUM BR 0.02% SOLUTION [Atrovent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | P |
IRBESARTAN 150 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in DE cover IRBESARTAN 150 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IRBESARTAN 300 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in DE cover IRBESARTAN 300 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IRBESARTAN 75 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in DE cover IRBESARTAN 75 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in DE cover IRBESARTAN-HCTZ 150-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide] ![Compare how all Medicare Part D PDP plans in DE cover IRBESARTAN-HCTZ 300-12.5 MG TABLET [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISENTRESS 100 MG POWDER PACKET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:60 /30Days |
ISENTRESS 100 MG TABLET CHEWABLE  |
4 |
Non-Preferred Drug |
40% | N/A | Q:180 /30Days |
ISENTRESS 25 MG TABLET CHEWABLE  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:180 /30Days |
ISENTRESS 400MG TABLET  |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ISENTRESS HD 600 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
ISIBLOOM 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in DE cover ISIBLOOM 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
ISOLYTE P IN 5% DEXTROSE INJECTION  |
4 |
Non-Preferred Drug |
40% | N/A | None |
ISOLYTE S IV SOLUTION PH7.4  |
4 |
Non-Preferred Drug |
40% | N/A | None |
ISONIAZID 100 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ISONIAZID 300 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
ISONIAZID 50MG/5ML SYRUP  |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOSORBIDE DINITRATE 10 MG TABLET [Wesorbide] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE DINITRATE 10 MG TABLET [Wesorbide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE DINITRATE 20 MG TABLET [Wesorbide] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE DINITRATE 20 MG TABLET [Wesorbide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE DN 30 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE DN 5 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE MN ER 30 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE MONONIT 10 MG TABLET [Monoket] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE MONONIT 10 MG TABLET [Monoket].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE MONONIT 20 MG TABLET [Monoket] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE MONONIT 20 MG TABLET [Monoket].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE MONONIT ER 120 MG TABLET 24H [Imdur] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE MONONIT ER 120 MG TABLET 24H [Imdur].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE MONONIT ER 60 MG TABLET 24H [Isotrate ER] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE MONONIT ER 60 MG TABLET 24H [Isotrate ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
ISOSORBIDE-HYDRALAZINE 20-37.5 TABLET [BiDil] ![Compare how all Medicare Part D PDP plans in DE cover ISOSORBIDE-HYDRALAZINE 20-37.5 TABLET [BiDil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:180 /30Days |
ISOTON GENTAMICIN 80MG/100ML  |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOTONIC GENTAMICIN 100 MG/100 ML  |
4 |
Non-Preferred Drug |
40% | N/A | None |
ISOTONIC GENTAMICIN 80 MG/50 ML  |
4 |
Non-Preferred Drug |
40% | N/A | None |
ISOTRETINOIN 10 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in DE cover ISOTRETINOIN 10 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
ISOTRETINOIN 20 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in DE cover ISOTRETINOIN 20 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
ISOTRETINOIN 25 MG CAPSULE [Absorica] ![Compare how all Medicare Part D PDP plans in DE cover ISOTRETINOIN 25 MG CAPSULE [Absorica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
ISOTRETINOIN 30 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in DE cover ISOTRETINOIN 30 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
ISOTRETINOIN 35 MG CAPSULE [Absorica] ![Compare how all Medicare Part D PDP plans in DE cover ISOTRETINOIN 35 MG CAPSULE [Absorica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
ISOTRETINOIN 40 MG CAPSULE [ZENATANE] ![Compare how all Medicare Part D PDP plans in DE cover ISOTRETINOIN 40 MG CAPSULE [ZENATANE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
ISTURISA 1 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P |
ISTURISA 5 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P |
ITRACONAZOLE 100 MG CAPSULE [Sporanox] ![Compare how all Medicare Part D PDP plans in DE cover ITRACONAZOLE 100 MG CAPSULE [Sporanox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IVABRADINE HCL 5 MG TABLET [Corlanor] ![Compare how all Medicare Part D PDP plans in DE cover IVABRADINE HCL 5 MG TABLET [Corlanor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P Q:60 /30Days |
IVABRADINE HCL 7.5 MG TABLET [Corlanor] ![Compare how all Medicare Part D PDP plans in DE cover IVABRADINE HCL 7.5 MG TABLET [Corlanor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P Q:60 /30Days |
IVERMECTIN 3 MG TABLET [Stromectol, Sklice] ![Compare how all Medicare Part D PDP plans in DE cover IVERMECTIN 3 MG TABLET [Stromectol, Sklice].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | P |
IWILFIN 192 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:240 /30Days |
IXCHIQ Chikungunya 18 Years + Injectable 0.5mL Live SDV Ea  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:1 /1Days |
IXIARO 6 UNIT(6 MCG)/0.5ML SYRINGE  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:0.50 /1Days |