2009 Medicare Part D Plan Formulary Information |
Fox Value Plan (S5557-028-0)
Benefit Details
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The Fox Value Plan (S5557-028-0) Formulary Drugs Starting with the Letter P in CMS PDP Region 27 which includes: CO
|
Drugs Starting with Letter P
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
PACERONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PACERONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PACLITAXEL INJECTION 30MG/5ML 50ML VIALMD ![Compare how all Medicare Part D PDP plans in CO cover PACLITAXEL INJECTION 30MG/5ML 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PACLITAXEL INJECTION 30MG/5ML VILMD CRTN ![Compare how all Medicare Part D PDP plans in CO cover PACLITAXEL INJECTION 30MG/5ML VILMD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD ![Compare how all Medicare Part D PDP plans in CO cover PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PACLITAXEL INJECTION USP 6MG/ML 300MG/50ML VIALMD ![Compare how all Medicare Part D PDP plans in CO cover PACLITAXEL INJECTION USP 6MG/ML 300MG/50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PALCAPS 10 33.2K-10K CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in CO cover PALCAPS 10 33.2K-10K CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PALCAPS 20 66.4-20-75 CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in CO cover PALCAPS 20 66.4-20-75 CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANCRELIPASE 16-48-48 CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PANCRELIPASE 16-48-48 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PANCRELIPASE CAP 4500UNIT ![Compare how all Medicare Part D PDP plans in CO cover PANCRELIPASE CAP 4500UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PANCRELIPASE TABLET 30000-8000UNT (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PANCRELIPASE TABLET 30000-8000UNT (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANCRON 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANCRON 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANCRON 20 CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover PANCRON 20 CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANGESTYME CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANGESTYME CN 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME CN 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANGESTYME CN 20 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME CN 20 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANGESTYME MT 16 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME MT 16 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PANGESTYME UL 12 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME UL 12 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANGESTYME UL 18 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME UL 18 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANGESTYME UL 20 CAPSULE EC ![Compare how all Medicare Part D PDP plans in CO cover PANGESTYME UL 20 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANOCAPS CAPSULE 4500UNT ![Compare how all Medicare Part D PDP plans in CO cover PANOCAPS CAPSULE 4500UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANOCAPS MT 16 CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PANOCAPS MT 16 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANOCAPS MT 20 CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PANOCAPS MT 20 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANOKASE 30K-8K-30K TABLET ![Compare how all Medicare Part D PDP plans in CO cover PANOKASE 30K-8K-30K TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANOKASE-16 60-16-60 TABLET ![Compare how all Medicare Part D PDP plans in CO cover PANOKASE-16 60-16-60 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in CO cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in CO cover PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT ![Compare how all Medicare Part D PDP plans in CO cover PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PARCOPA 10MG/100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PARCOPA 10MG/100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PARCOPA 25MG/100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PARCOPA 25MG/100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PARCOPA 25MG/250MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PARCOPA 25MG/250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PARNATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PARNATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PAROMOMYCIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PAROMOMYCIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PAROXETINE FILM COATED 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE FILM COATED 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PAROXETINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PAROXETINE HCL 10MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE HCL 10MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PAROXETINE HCL 30MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE HCL 30MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PAROXETINE HCL TABLET 24 12.5MG ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE HCL TABLET 24 12.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PAROXETINE HCL TABLET 24 25MG ![Compare how all Medicare Part D PDP plans in CO cover PAROXETINE HCL TABLET 24 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PATANOL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in CO cover PATANOL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PEDI-DRI TOPICAL POWDER ![Compare how all Medicare Part D PDP plans in CO cover PEDI-DRI TOPICAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in CO cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in CO cover PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PEG-INTRON 100MCG KIT ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON 100MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON 160MCG KIT ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON 160MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON 240MCG KIT ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON 240MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON 300MCG KIT ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON 300MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON REDIPEN 120MCG ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN 120MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON REDIPEN 150MCG ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN 150MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON REDIPEN 50MCG ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON REDIPEN 50MCG 4PK ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN 50MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON REDIPEN 80MCG ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN 80MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEG-INTRON REDIPEN 80MCG 4PK ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN 80MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEG-INTRON REDIPEN PAK 4 ![Compare how all Medicare Part D PDP plans in CO cover PEG-INTRON REDIPEN PAK 4.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PEGANONE 250MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PEGANONE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PEGASYS 180MCG/0.5ML CONV.PK ![Compare how all Medicare Part D PDP plans in CO cover PEGASYS 180MCG/0.5ML CONV.PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PEGINTRON REDIPEN 150MCG 4PK ![Compare how all Medicare Part D PDP plans in CO cover PEGINTRON REDIPEN 150MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENICILLIN V POTASSIUM 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN V POTASSIUM 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in CO cover PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PENTOPAK 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover PENTOPAK 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PENTOSTATIN FOR INJECTION 10MG/VIAL ![Compare how all Medicare Part D PDP plans in CO cover PENTOSTATIN FOR INJECTION 10MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PENTOXIL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover PENTOXIL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PEPCID SOLUTION 40MG 24 X 400MG BOT ![Compare how all Medicare Part D PDP plans in CO cover PEPCID SOLUTION 40MG 24 X 400MG BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PERIOGARD 0.12% ORAL RINSE ![Compare how all Medicare Part D PDP plans in CO cover PERIOGARD 0.12% ORAL RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PERMETHRIN 5% CREAM ![Compare how all Medicare Part D PDP plans in CO cover PERMETHRIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PERPHENAZINE 16MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PERPHENAZINE 16MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PERPHENAZINE 2MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PERPHENAZINE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PERPHENAZINE 4MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PERPHENAZINE 4MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERPHENAZINE 8MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PERPHENAZINE 8MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PHENADOZ 12.5MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in CO cover PHENADOZ 12.5MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PHENADOZ 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in CO cover PHENADOZ 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in CO cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP ![Compare how all Medicare Part D PDP plans in CO cover PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PHOSLO 667MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PHOSLO 667MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PHOSPHOLINE IODIDE 0.125% ![Compare how all Medicare Part D PDP plans in CO cover PHOSPHOLINE IODIDE 0.125%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PHOTOFRIN 75MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover PHOTOFRIN 75MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PILOCARPINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PILOCARPINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PILOCARPINE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PILOCARPINE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PILOPINE HS 4% EYE GEL ![Compare how all Medicare Part D PDP plans in CO cover PILOPINE HS 4% EYE GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PINDOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PINDOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PINDOLOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PINDOLOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PIPERACILLIN 2GM VIAL ![Compare how all Medicare Part D PDP plans in CO cover PIPERACILLIN 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PIPERACILLIN 3GM VIAL ![Compare how all Medicare Part D PDP plans in CO cover PIPERACILLIN 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PIPERACILLIN 40GM BULK VIAL ![Compare how all Medicare Part D PDP plans in CO cover PIPERACILLIN 40GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PIPERACILLIN 4GM VIAL ![Compare how all Medicare Part D PDP plans in CO cover PIPERACILLIN 4GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PIROXICAM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PIROXICAM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PIROXICAM 20MG CAPSULE (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PIROXICAM 20MG CAPSULE (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PLAN B 0.75MG TABLET 2 BLPK ![Compare how all Medicare Part D PDP plans in CO cover PLAN B 0.75MG TABLET 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLARETASE 8000 30K-8K-30K TABLET ![Compare how all Medicare Part D PDP plans in CO cover PLARETASE 8000 30K-8K-30K TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PLASMA-LYTE 148 IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover PLASMA-LYTE 148 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLASMA-LYTE 148/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in CO cover PLASMA-LYTE 148/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLASMA-LYTE 56 INJECTION 32;128 MG/100ML; ![Compare how all Medicare Part D PDP plans in CO cover PLASMA-LYTE 56 INJECTION 32;128 MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLASMA-LYTE 56/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in CO cover PLASMA-LYTE 56/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML; ![Compare how all Medicare Part D PDP plans in CO cover PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLAVIX 300MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PLAVIX 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PLAVIX 75MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PLAVIX 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in CO cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POLY-DEX 0.1% SUSPENSION DROPS ![Compare how all Medicare Part D PDP plans in CO cover POLY-DEX 0.1% SUSPENSION DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POLY-DEX 3.5-10K-.1 OINTMENT ![Compare how all Medicare Part D PDP plans in CO cover POLY-DEX 3.5-10K-.1 OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT) ![Compare how all Medicare Part D PDP plans in CO cover POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in CO cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in CO cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in CO cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 10MEQ CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 10MEQ CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 10MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 10MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 10MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 10MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 20MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 20MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 20MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 30MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 30MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9% ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 40MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 40MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE ER CPCR 8MEQ ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE ER CPCR 8MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND 0.2% NACL SOLUTION FOR INJECTION USP 0.15% 250ML X 24 CASE ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND 0.2% NACL SOLUTION FOR INJECTION USP 0.15% 250ML X 24 CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND NACL SOLUTION FOR INJECTION 0.075% 1000ML PLASTIC BAGS X 12 CA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND NACL SOLUTION FOR INJECTION 0.075% 1000ML PLASTIC BAGS X 12 CA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION USP 0.15% 1000ML PLASTIC BAGS X 12 CASE ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION USP 0.15% 1000ML PLASTIC BAGS X 12 CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN DEXTROSE AND SODIUM CHLORIDE INJECTION 5-30-.225 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN DEXTROSE AND SODIUM CHLORIDE INJECTION 5-30-.225 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION 0.15%-0.9% 12 X 1000ML BAG ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION 0.15%-0.9% 12 X 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE TABLET ER USP 750MG (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE TABLET ER USP 750MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CHLORIDE TABLET ERD 1500MG (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CHLORIDE TABLET ERD 1500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
POTASSIUM CITRATE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CITRATE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
POTASSIUM CITRATE 5MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover POTASSIUM CITRATE 5MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRANDIN 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRANDIN 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PRANDIN 1MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRANDIN 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PRANDIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRANDIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PRAVASTATIN SODIUM 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PRAVASTATIN SODIUM 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRAVASTATIN SODIUM 20MG TABLET 500 BOT ![Compare how all Medicare Part D PDP plans in CO cover PRAVASTATIN SODIUM 20MG TABLET 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRAVASTATIN SODIUM 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PRAVASTATIN SODIUM 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PRAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PRAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRECOSE 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRECOSE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PRECOSE 25MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRECOSE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PRECOSE 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRECOSE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PREDNISOLONE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREDNISOLONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISOLONE 5MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE 5MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREDNISOLONE 5MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE 5MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in CO cover PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREDNISONE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISONE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISONE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PREDNISONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMARIN 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMARIN 0.625MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN 0.625MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMARIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMARIN 1.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN 1.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMARIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMARIN VAGINAL CREAM /APPL ![Compare how all Medicare Part D PDP plans in CO cover PREMARIN VAGINAL CREAM /APPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | Q:43 /30Days |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in CO cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | P |
PREMPHASE 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREMPHASE 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMPRO 0.3MG/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREMPRO 0.3MG/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMPRO 0.45/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREMPRO 0.45/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMPRO 0.625/2.5MG TABLET DIALPK ![Compare how all Medicare Part D PDP plans in CO cover PREMPRO 0.625/2.5MG TABLET DIALPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PREMPRO 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREMPRO 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRENATAL RX 1 TABLET 4000UNT-400UNT (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PRENATAL RX 1 TABLET 4000UNT-400UNT (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREVACID 15MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover PREVACID 15MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PREVACID 15MG SOLUTAB ![Compare how all Medicare Part D PDP plans in CO cover PREVACID 15MG SOLUTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PREVACID 30MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in CO cover PREVACID 30MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PREVACID 30MG SOLUTAB ![Compare how all Medicare Part D PDP plans in CO cover PREVACID 30MG SOLUTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PREVACID NAP KIT 500MG ![Compare how all Medicare Part D PDP plans in CO cover PREVACID NAP KIT 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PREVALITE POW 4GM ![Compare how all Medicare Part D PDP plans in CO cover PREVALITE POW 4GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREVALITE POW 4GM PK ![Compare how all Medicare Part D PDP plans in CO cover PREVALITE POW 4GM PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREVIFEM 0.25-0.035 TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREVIFEM 0.25-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PREVPAC PATIENT PACK ![Compare how all Medicare Part D PDP plans in CO cover PREVPAC PATIENT PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | Q:14 /365Days |
PREZISTA 300MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREZISTA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREZISTA TABLET ![Compare how all Medicare Part D PDP plans in CO cover PREZISTA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in CO cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PREZISTA TABLETS 400MG 60 TABLETS BOT ![Compare how all Medicare Part D PDP plans in CO cover PREZISTA TABLETS 400MG 60 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PRIFTIN 150MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PRIFTIN 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PRIMAXIN 250MG VIAL ADD-VANTAG ![Compare how all Medicare Part D PDP plans in CO cover PRIMAXIN 250MG VIAL ADD-VANTAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PRIMAXIN I.M. 500MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover PRIMAXIN I.M. 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PRIMAXIN IV 250MG VIAL ![Compare how all Medicare Part D PDP plans in CO cover PRIMAXIN IV 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in CO cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in CO cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PRIMIDONE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PRIMIDONE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PRIMIDONE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PRIMIDONE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRISTIQ 100MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in CO cover PRISTIQ 100MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | S |
PRISTIQ 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in CO cover PRISTIQ 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | S |
PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in CO cover PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROBENECID 500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROBENECID 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROBENECID/COLCHICINE TABLET S ![Compare how all Medicare Part D PDP plans in CO cover PROBENECID/COLCHICINE TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT ![Compare how all Medicare Part D PDP plans in CO cover PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P |
PROCANBID 1000MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover PROCANBID 1000MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PROCANBID 500MG TABLET SA ![Compare how all Medicare Part D PDP plans in CO cover PROCANBID 500MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN ![Compare how all Medicare Part D PDP plans in CO cover PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROCHLORPERAZINE MALEATE 25MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in CO cover PROCHLORPERAZINE MALEATE 25MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
PROCRIT 20000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in CO cover PROCRIT 20000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P Q:12 /28Days |
PROCRIT 3000U/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROCRIT 3000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P Q:12 /28Days |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in CO cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
PROCRIT 4000U/ML VIAL 25 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROCRIT 4000U/ML VIAL 25 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P Q:12 /28Days |
PROCTOCREAM-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in CO cover PROCTOCREAM-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in CO cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in CO cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROGLYCEM 50MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in CO cover PROGLYCEM 50MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROGRAF 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PROGRAF 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PROGRAF 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PROGRAF 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PROGRAF 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PROGRAF 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PROGRAF 5MG/ML AMPULE ![Compare how all Medicare Part D PDP plans in CO cover PROGRAF 5MG/ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PROLEUKIN 22 MILLION UNITS VL ![Compare how all Medicare Part D PDP plans in CO cover PROLEUKIN 22 MILLION UNITS VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
PROMETHAZINE 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL 12.5MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 12.5MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL 25MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 25MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHAZINE HCL 50MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 50MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL 6.25MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL 6.25MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHAZINE SYRUP PLAIN 6.25MG 16 FL OZ BOT ![Compare how all Medicare Part D PDP plans in CO cover PROMETHAZINE SYRUP PLAIN 6.25MG 16 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHEGAN 12.5MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in CO cover PROMETHEGAN 12.5MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in CO cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in CO cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPAFENONE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPAFENONE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPAFENONE HCL 300MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPAFENONE HCL 300MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPANTHELINE 15MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPANTHELINE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPOXY-N/APAP 100-500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPOXY-N/APAP 100-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPOXY-N/APAP 100-650 TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPOXY-N/APAP 100-650 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPOXY-N/APAP 50-325 TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPOXY-N/APAP 50-325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPOXYPHENE HCL CAPSULES 65MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPOXYPHENE HCL CAPSULES 65MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL 60MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL HCL 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPRANOLOL HCL CAPSULES ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL CAPSULES ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL HCL TABLET USP 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL TABLET USP 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPRANOLOL HCL TABLET USP 40MG (1000 CT) ![Compare how all Medicare Part D PDP plans in CO cover PROPRANOLOL HCL TABLET USP 40MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in CO cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | None |
PROVIGIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROVIGIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P Q:30 /30Days |
PROVIGIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PROVIGIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PULMICORT .25MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in CO cover PULMICORT .25MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PULMICORT 0.5MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in CO cover PULMICORT 0.5MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PULMICORT 1MG/2ML AMPUL FOR NEBULIZATION ![Compare how all Medicare Part D PDP plans in CO cover PULMICORT 1MG/2ML AMPUL FOR NEBULIZATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$75.00 | $225.00 | P |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in CO cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in CO cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in CO cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | P |
PYLERA 125-125MG CAPSULE ![Compare how all Medicare Part D PDP plans in CO cover PYLERA 125-125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$34.00 | $102.00 | None |
PYRAZINAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PYRAZINAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |
PYRIDOSTIGMINE BROMIDE 60MG TABLET ![Compare how all Medicare Part D PDP plans in CO cover PYRIDOSTIGMINE BROMIDE 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$27.00 | $81.00 | None |