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Januvia
1.
Carrier Tier Pa)ent Cost- Share Subject to Deduc)ble? Plan Drug Deduc)ble Approximate Annual Cost A
2 $55 No N/A $700 B Not Covered $430 N/A N/A $5,100 C 3 $50 No N/A $600 D 4 $215 Yes $5,000* $3,900 E 4 $75 Yes $500 $1,300 F 4 $129 Yes $2,750* $1,900 Es>mated annual costs for Januvia for 6 representa>ve Silver plans * Drug deduc*ble is included in plan deduc*ble
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