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Aetna Medicare 2014 Formularies Top Medicare Part D Drugs Top 100 Drug List (by rank) with Pharmacy Pricing† This is a list of 100 drugs commonly used by seniors.Below are the copay tiers for each of the Aetna Medicare formularies and drug price as of October 2013. Drug price is based on Medicare Plan Finder data and is the average price of four national chains based upon default strength and dosing. Actual costs may differ. This list is for il ustrative purposes only and does not display al covered drugs. For a complete listing of drugs, members should refer to the comprehensive formulary guide. Drug Price† Quantity per (Copay for Tier 1, Drug Name Strength SaverPlus Enhanced Coinsurance for Formulary1 Formulary2 Formulary3 Tiers 2 and 3) atorvastatin tab (generic LIPITOR)
11 metoprolol er (generic TOPROL XL)
13 potassium chloride cr, er, sr tab
19 NEXIUM cap
21 triamterene and hydrochlorothiazide cap
22 lansoprazole (generic PREVACID)
24 SPIRIVA
25 escitalopram (generic LEXAPRO)
27 DIOVAN
30 SYNTHROID For Agent Use Only. Not to be shared with Medicare beneficiaries. Drug Price† Drug Name Strength Quantity per (Copay for Tier 1, SaverPlus Enhanced Coinsurance for Formulary1 Formulary2 Formulary3 Tiers 2 and 3)
31 SYMBICORT 160 mcg/4.5 mcg; 1
32 PROVENTIL HFA 1 inhaler
33 donepezil tab (generic ARICEPT)
37 pantoprazole (generic PROTONIX)
43 risperidone tab (generic RISPERDAL)
44 ADVAIR 250 mcg/50 mcg; 1
48 VYTORIN 10 mg/20 mg
49 AVANDIA
50 sertraline tab (generic ZOLOFT )
51 tamsulosin cap (generic FLOMAX)
53 pioglitazone tab (generic ACTOS)
54 amlodipine-benazepril (generic LOTREL)
61 montelukast (generic SINGULAIR)
64 lisinopril and hydrochlorothiazide
65 CELEBREX
66 LANTUS
68 PREMARIN tab For Agent Use Only. Not to be shared with Medicare beneficiaries. Drug Price† Drug Name Strength Quantity per (Copay for Tier 1, SaverPlus Enhanced Coinsurance for Formulary1 Formulary2 Formulary3 Tiers 2 and 3)
71 valsartan-hydrochlorothiazide (generic
73 LEVEMIR
75 levofloxacin (generic LEVAQUIN)
77 CRESTOR
82 NAMENDA
83 venlafaxine ER (generic EFFEXOR XR)
84 DETROL LA
91 JANUVIA
96 COMBIVENT 1 inhaler
99 SEROQUEL XR This is a partial listing of drugs available on Aetna Medicare 2014 formularies as of October, 2013. For a complete and current listing, review the Comprehensive Formulary Drug Lists available at www.aetnamedicare.com. Tier placement for Aetna / CVS pharmacy Prescription Drug Plan (PDP) Tier placement for Aetna Medicare Advantage Prescription Drug (MAPD) plans Tier placement for Aetna Medicare Advantage Prescription Drug (MAPD) plans and Aetna Medicare Rx Premier (PDP) Average price of the four national chains (Walmart, CVS, Walgreens, Rite Aid) is based on Medicare Plan Finder default strength and dosing data. The member's actual cost-share may differ from the prices shown based upon pharmacy used to fil a prescription, as well as strength and dosing. NC Drug not covered on this formulary For Agent Use Only. Not to be shared with Medicare beneficiaries.
U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER) Center for Biologics Evaluation and Research (CBER) December 2000 Additional copies are available from: Office of Training and Communications Division of Communications Management (Internet) http://www.fda.gov/cder/guidance/index.htm Office of Communication
remain the perpetual friends of the Republic of Texas. friendship between the Republic of Texas cultivate and secure their friendship and promote their interest and happiness, do being solicitous to secure the peace and friendship of the Lipan tribe of Indians, them as their wants may require and their behalf of said Republic, and with a view to further and secure the peace and friendship
Aetna Medicare 2014 Formularies