| Tier ID | Drug type | Description |
|---|---|---|
| 01 | Preferred generic | Lowest-cost drugs, mostly generics |
| 02 | Nonpreferred generic | Medium-cost drugs, mostly generics and some brand-name drugs |
| 03 | Preferred brand | High-cost drugs, mostly brand-name drugs |
| 04 | Nonpreferred brand | Higher-cost drugs, mostly brand-name drugs |
| 05 | Specialty | Highest-cost brand-name and generic drugs |
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