Formulary Finder for Prescription Drug Plans
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http://formularyfinder.medicare.gov/formularyfinder/matchedDrugs.asp?v...
Find a Medicare Prescription Drug Plan Plan Formulary Finder: Plan Formulary Status Please view the formulary status for the drugs you selected for the Original Medicare plan.
Drug Coverage Information Limitations/Restrictions
Drug Name
Formulary Prior Status Authorization [What is this?] [What is this?]
Quantity Limits [What is this?]
Step Therapy [What is this?]
Cymbalta CAP 60MG
TIER 2
NO
NO
NO
GABAPENTIN TAB 600MG
TIER 1
NO
YES
NO
HYDROCHLOROTHIAZIDE TAB 25MG
TIER 1
NO
NO
NO
HYDROCODONE/ACETAMINOPHEN TAB 10-750MG
TIER 1
NO
NO
NO
Lyrica CAP 50MG
TIER 2
NO
YES
NO
Provigil TAB 200MG
TIER 2
YES
NO
NO
Rebif INJ 44/0.5
TIER 2
NO
NO
NO
ROPINIROLE HCL TAB 0.25MG
TIER 1
NO
NO
NO
SERTRALINE HCL TAB 25MG
TIER 1
NO
NO
NO
SIMVASTATIN TAB 20MG
TIER 1
NO
NO
NO
TIZANIDINE HCL TAB 4MG
TIER 1
NO
NO
NO
Vigamox DRO 0.5%
TIER 2
NO
NO
NO
For more information, read: How new Medicare drug plans will provide you with high-quality, low cost drug coverage.
12/19/2008 5:03 PM