2009 Medicare Part D Plan Formulary Information |
Blue MedicareRx Plus (S5726-014-0)
Sanctioned Plan
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The Blue MedicareRx Plus (S5726-014-0) Formulary Drugs Starting with the Letter P in CMS PDP Region 24 which includes: KS
|
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 100MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PACERONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PACERONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PACERONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PACERONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PACLITAXEL INJECTION 30MG/5ML 50ML VIALMD ![Compare how all Medicare Part D PDP plans in KS cover PACLITAXEL INJECTION 30MG/5ML 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PACLITAXEL INJECTION 30MG/5ML VILMD CRTN ![Compare how all Medicare Part D PDP plans in KS cover PACLITAXEL INJECTION 30MG/5ML VILMD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD ![Compare how all Medicare Part D PDP plans in KS cover PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PACLITAXEL INJECTION USP 6MG/ML 300MG/50ML VIALMD ![Compare how all Medicare Part D PDP plans in KS cover PACLITAXEL INJECTION USP 6MG/ML 300MG/50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PALCAPS 10 33.2K-10K CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in KS cover PALCAPS 10 33.2K-10K CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PALCAPS 20 66.4-20-75 CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in KS cover PALCAPS 20 66.4-20-75 CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PALGIC 4MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in KS cover PALGIC 4MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAMIDRONATE 60MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PAMIDRONATE 60MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PAMIDRONATE DISODIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in KS cover PAMIDRONATE DISODIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PAMIDRONATE DISODIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in KS cover PAMIDRONATE DISODIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in KS cover PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in KS cover PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PANCREASE MT 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANCREASE MT 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANCREASE MT 16 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANCREASE MT 16 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANCREASE MT 20 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANCREASE MT 20 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANCREASE MT 4 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANCREASE MT 4 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANCRECARB MS-16 52-16-52 CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in KS cover PANCRECARB MS-16 52-16-52 CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANCRECARB MS-4 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANCRECARB MS-4 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANCRECARB MS-8 PANCRELIPASE CAPSULES 40000UNT (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PANCRECARB MS-8 PANCRELIPASE CAPSULES 40000UNT (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANCRELIPASE 16-48-48 CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PANCRELIPASE 16-48-48 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANCRELIPASE CAP 4500UNIT ![Compare how all Medicare Part D PDP plans in KS cover PANCRELIPASE CAP 4500UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANCRELIPASE TABLET 30000-8000UNT (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PANCRELIPASE TABLET 30000-8000UNT (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANCRON 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANCRON 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANCRON 20 CAPSULE SA ![Compare how all Medicare Part D PDP plans in KS cover PANCRON 20 CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGESTYME CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGESTYME CN 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME CN 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGESTYME CN 20 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME CN 20 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGESTYME MT 16 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME MT 16 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGESTYME UL 12 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME UL 12 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANGESTYME UL 18 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME UL 18 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGESTYME UL 20 CAPSULE EC ![Compare how all Medicare Part D PDP plans in KS cover PANGESTYME UL 20 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANGLOBULIN 12GM ![Compare how all Medicare Part D PDP plans in KS cover PANGLOBULIN 12GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PANGLOBULIN 6GM VIAL ![Compare how all Medicare Part D PDP plans in KS cover PANGLOBULIN 6GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PANGLOBULIN INJ 1GM ![Compare how all Medicare Part D PDP plans in KS cover PANGLOBULIN INJ 1GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PANGLOBULIN INJ 3GM ![Compare how all Medicare Part D PDP plans in KS cover PANGLOBULIN INJ 3GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PANOCAPS CAPSULE 4500UNT ![Compare how all Medicare Part D PDP plans in KS cover PANOCAPS CAPSULE 4500UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANOCAPS MT 16 CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PANOCAPS MT 16 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANOCAPS MT 20 CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PANOCAPS MT 20 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PANOKASE 30K-8K-30K TABLET ![Compare how all Medicare Part D PDP plans in KS cover PANOKASE 30K-8K-30K TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PANOKASE-16 60-16-60 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PANOKASE-16 60-16-60 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in KS cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in KS cover PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:30 /30Days |
PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT ![Compare how all Medicare Part D PDP plans in KS cover PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:30 /30Days |
PARCAINE 0.5% DROPS ![Compare how all Medicare Part D PDP plans in KS cover PARCAINE 0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PAROMOMYCIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PAROMOMYCIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PAROXETINE 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:60 /30Days |
PAROXETINE FILM COATED 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE FILM COATED 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:30 /30Days |
PAROXETINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:30 /30Days |
PAROXETINE HCL 10MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE HCL 10MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:1200 /30Days |
PAROXETINE HCL 30MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE HCL 30MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:60 /30Days |
PAROXETINE HCL TABLET 24 12.5MG ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE HCL TABLET 24 12.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE HCL TABLET 24 25MG ![Compare how all Medicare Part D PDP plans in KS cover PAROXETINE HCL TABLET 24 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:30 /30Days |
PATADAY 0.2% DROPS ![Compare how all Medicare Part D PDP plans in KS cover PATADAY 0.2% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:5 /30Days |
PATANOL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in KS cover PATANOL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:5 /30Days |
PAXIL CR 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PAXIL CR 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:30 /30Days |
PAXIL CR 25MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PAXIL CR 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:30 /30Days |
PAXIL CR 37.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PAXIL CR 37.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:60 /30Days |
PEDI-DRI TOPICAL POWDER ![Compare how all Medicare Part D PDP plans in KS cover PEDI-DRI TOPICAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in KS cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in KS cover PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PEG-INTRON 100MCG KIT ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON 100MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEG-INTRON 160MCG KIT ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON 160MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON 240MCG KIT ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON 240MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON 300MCG KIT ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON 300MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN 120MCG ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN 120MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN 150MCG ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN 150MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN 50MCG ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN 50MCG 4PK ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN 50MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN 80MCG ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN 80MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN 80MCG 4PK ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN 80MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEG-INTRON REDIPEN PAK 4 ![Compare how all Medicare Part D PDP plans in KS cover PEG-INTRON REDIPEN PAK 4.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEGANONE 250MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PEGANONE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEGASYS 180MCG/0.5ML CONV.PK ![Compare how all Medicare Part D PDP plans in KS cover PEGASYS 180MCG/0.5ML CONV.PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PEGINTRON REDIPEN 150MCG 4PK ![Compare how all Medicare Part D PDP plans in KS cover PEGINTRON REDIPEN 150MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PENICILLIN G POTASSIUM 1MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G POTASSIUM 1MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENICILLIN V POTASSIUM 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN V POTASSIUM 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in KS 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 Preferred Generic |
$9.00 | $13.50 | None |
PENTAM 300 INJ 300MG ![Compare how all Medicare Part D PDP plans in KS cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in KS cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PENTAZOCINE/ACETAMIN TABLET ![Compare how all Medicare Part D PDP plans in KS cover PENTAZOCINE/ACETAMIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PENTAZOCINE/NALOXONE HCL 50-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PENTAZOCINE/NALOXONE HCL 50-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:180 /30Days |
PENTOPAK 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover PENTOPAK 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PENTOSTATIN FOR INJECTION 10MG/VIAL ![Compare how all Medicare Part D PDP plans in KS cover PENTOSTATIN FOR INJECTION 10MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PENTOXIL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover PENTOXIL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEPCID PREMX SOL 20MG/50M ![Compare how all Medicare Part D PDP plans in KS cover PEPCID PREMX SOL 20MG/50M.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PERFOROMIST 20MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in KS cover PERFOROMIST 20MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:120 /30Days |
PERIOGARD 0.12% ORAL RINSE ![Compare how all Medicare Part D PDP plans in KS cover PERIOGARD 0.12% ORAL RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PERMETHRIN 5% CREAM ![Compare how all Medicare Part D PDP plans in KS cover PERMETHRIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PERPHENAZINE 16MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PERPHENAZINE 16MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PERPHENAZINE 2MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PERPHENAZINE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PERPHENAZINE 4MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PERPHENAZINE 4MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PERPHENAZINE 8MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PERPHENAZINE 8MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PFIZERPEN 20MMU VIAL ![Compare how all Medicare Part D PDP plans in KS cover PFIZERPEN 20MMU VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PFIZERPEN 5MMU VIAL ![Compare how all Medicare Part D PDP plans in KS cover PFIZERPEN 5MMU VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PHENADOZ 12.5MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in KS cover PHENADOZ 12.5MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENADOZ 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in KS cover PHENADOZ 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PHENERGAN 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PHENERGAN 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PHENERGAN 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PHENERGAN 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PHENYTEK 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PHENYTEK 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PHENYTEK 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PHENYTEK 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in KS cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP ![Compare how all Medicare Part D PDP plans in KS cover PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PHOSLO 667MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PHOSLO 667MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PHOTOFRIN 75MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PHOTOFRIN 75MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PHRENILIN W/CAFF/CODEINE CP ![Compare how all Medicare Part D PDP plans in KS cover PHRENILIN W/CAFF/CODEINE CP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHYSIOLYTE SOLUTION FOR IRRIGATION ![Compare how all Medicare Part D PDP plans in KS cover PHYSIOLYTE SOLUTION FOR IRRIGATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PHYSIOSOL IRRIGATION SOL ![Compare how all Medicare Part D PDP plans in KS cover PHYSIOSOL IRRIGATION SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PHYSIOSOL IRRIGATION SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PHYSIOSOL IRRIGATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PILOCARPINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PILOCARPINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PILOCARPINE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PILOCARPINE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PILOPINE HS 4% EYE GEL ![Compare how all Medicare Part D PDP plans in KS cover PILOPINE HS 4% EYE GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:8 /30Days |
PINDOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PINDOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PINDOLOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PINDOLOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PIPERACILLIN 2GM VIAL ![Compare how all Medicare Part D PDP plans in KS cover PIPERACILLIN 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PIPERACILLIN 3GM VIAL ![Compare how all Medicare Part D PDP plans in KS cover PIPERACILLIN 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PIPERACILLIN 40GM BULK VIAL ![Compare how all Medicare Part D PDP plans in KS cover PIPERACILLIN 40GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIPERACILLIN 4GM VIAL ![Compare how all Medicare Part D PDP plans in KS cover PIPERACILLIN 4GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PIROXICAM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PIROXICAM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PIROXICAM 20MG CAPSULE (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PIROXICAM 20MG CAPSULE (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PLARETASE 8000 30K-8K-30K TABLET ![Compare how all Medicare Part D PDP plans in KS cover PLARETASE 8000 30K-8K-30K TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PLASMA-LYTE 148 IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PLASMA-LYTE 148 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PLASMA-LYTE 148/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in KS cover PLASMA-LYTE 148/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PLASMA-LYTE 56 INJECTION 32;128 MG/100ML; ![Compare how all Medicare Part D PDP plans in KS cover PLASMA-LYTE 56 INJECTION 32;128 MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PLASMA-LYTE 56/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in KS cover PLASMA-LYTE 56/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML; ![Compare how all Medicare Part D PDP plans in KS cover PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PLASMA-LYTE INJ-R ![Compare how all Medicare Part D PDP plans in KS cover PLASMA-LYTE INJ-R.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PLATINOL AQ INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PLATINOL AQ INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PLAVIX 300MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PLAVIX 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PLAVIX 75MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PLAVIX 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in KS cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POLY-DEX 0.1% SUSPENSION DROPS ![Compare how all Medicare Part D PDP plans in KS cover POLY-DEX 0.1% SUSPENSION DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POLY-DEX 3.5-10K-.1 OINTMENT ![Compare how all Medicare Part D PDP plans in KS cover POLY-DEX 3.5-10K-.1 OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POLYCIN-B 500-10KU/G OINTMENT ![Compare how all Medicare Part D PDP plans in KS cover POLYCIN-B 500-10KU/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT) ![Compare how all Medicare Part D PDP plans in KS cover POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POLYGAM S/D 0.5GM VL W/DILUEN ![Compare how all Medicare Part D PDP plans in KS cover POLYGAM S/D 0.5GM VL W/DILUEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
POLYGAM S/D 10GM VL W/DILUENT ![Compare how all Medicare Part D PDP plans in KS cover POLYGAM S/D 10GM VL W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
POLYGAM S/D 2.5GM VL W/DILUEN ![Compare how all Medicare Part D PDP plans in KS cover POLYGAM S/D 2.5GM VL W/DILUEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
POLYGAM S/D 5GM VL W/DILUENT ![Compare how all Medicare Part D PDP plans in KS cover POLYGAM S/D 5GM VL W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
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 KS cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:20 /30Days |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in KS cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:20 /30Days |
POLYMYXIN B SULFATE VIAL ![Compare how all Medicare Part D PDP plans in KS cover POLYMYXIN B SULFATE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:28 /28Days |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | 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 0.2% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 10MEQ CAPSULE SA ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 10MEQ CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CHLORIDE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CHLORIDE 10MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 10MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 10MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 10MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CHLORIDE 20MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 20MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 20MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 30MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 30MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9% ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 40MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 40MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE ER CPCR 8MEQ ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE ER CPCR 8MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | 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 KS 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) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | 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 KS 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) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | 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 KS 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) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | 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 KS 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) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION 0.15%-0.9% 12 X 1000ML BAG ![Compare how all Medicare Part D PDP plans in KS 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) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
POTASSIUM CHLORIDE TABLET ER USP 750MG (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE TABLET ER USP 750MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CHLORIDE TABLET ERD 1500MG (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CHLORIDE TABLET ERD 1500MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CITRATE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CITRATE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
POTASSIUM CITRATE 5MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in KS cover POTASSIUM CITRATE 5MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRAVASTATIN SODIUM 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PRAVASTATIN SODIUM 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRAVASTATIN SODIUM 20MG TABLET 500 BOT ![Compare how all Medicare Part D PDP plans in KS cover PRAVASTATIN SODIUM 20MG TABLET 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRAVASTATIN SODIUM 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PRAVASTATIN SODIUM 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRAVASTATIN SODIUM 80MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in KS cover PRAVASTATIN SODIUM 80MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PRAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PRAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNICARBATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in KS cover PREDNICARBATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in KS cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISOLONE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISOLONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISOLONE 5MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE 5MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISOLONE 5MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE 5MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:20 /30Days |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:20 /30Days |
PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in KS cover PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREGNYL INJ 10000UNT ![Compare how all Medicare Part D PDP plans in KS cover PREGNYL INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PREMARIN 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMARIN 0.625MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN 0.625MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMARIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMARIN 1.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN 1.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMARIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PREMARIN VAGINAL CREAM /APPL ![Compare how all Medicare Part D PDP plans in KS cover PREMARIN VAGINAL CREAM /APPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:86 /30Days |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PREMPHASE 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREMPHASE 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMPRO 0.3MG/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREMPRO 0.3MG/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMPRO 0.45/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREMPRO 0.45/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMPRO 0.625/2.5MG TABLET DIALPK ![Compare how all Medicare Part D PDP plans in KS cover PREMPRO 0.625/2.5MG TABLET DIALPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREMPRO 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREMPRO 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | 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 KS cover PRENATAL RX 1 TABLET 4000UNT-400UNT (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREVACID 15MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in KS cover PREVACID 15MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:30 /30Days |
PREVACID 15MG SOLUTAB ![Compare how all Medicare Part D PDP plans in KS cover PREVACID 15MG SOLUTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:30 /30Days |
PREVACID 30MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in KS cover PREVACID 30MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:30 /30Days |
PREVACID 30MG SOLUTAB ![Compare how all Medicare Part D PDP plans in KS cover PREVACID 30MG SOLUTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:30 /30Days |
PREVALITE POW 4GM ![Compare how all Medicare Part D PDP plans in KS cover PREVALITE POW 4GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREVALITE POW 4GM PK ![Compare how all Medicare Part D PDP plans in KS cover PREVALITE POW 4GM PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PREVIFEM 0.25-0.035 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREVIFEM 0.25-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:28 /28Days |
PREVPAC PATIENT PACK ![Compare how all Medicare Part D PDP plans in KS cover PREVPAC PATIENT PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PREZISTA 300MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREZISTA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PREZISTA TABLET ![Compare how all Medicare Part D PDP plans in KS cover PREZISTA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in KS cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PREZISTA TABLETS 400MG 60 TABLETS BOT ![Compare how all Medicare Part D PDP plans in KS cover PREZISTA TABLETS 400MG 60 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PRIFTIN 150MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PRIFTIN 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PRIMAQUINE 26.3MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PRIMAQUINE 26.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PRIMAXIN 250MG VIAL ADD-VANTAG ![Compare how all Medicare Part D PDP plans in KS cover PRIMAXIN 250MG VIAL ADD-VANTAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PRIMAXIN I.M. 500MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PRIMAXIN I.M. 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PRIMAXIN IV 250MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PRIMAXIN IV 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in KS cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in KS cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PRIMIDONE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PRIMIDONE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PRIMIDONE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PRIMIDONE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | 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 KS cover PRISTIQ 100MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | P Q:30 /30Days |
PRISTIQ 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in KS cover PRISTIQ 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | P Q:30 /30Days |
PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in KS cover PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:27 /30Days |
PROBENECID 500MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROBENECID 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROBENECID/COLCHICINE TABLET S ![Compare how all Medicare Part D PDP plans in KS cover PROBENECID/COLCHICINE TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROCAINAMIDE 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROCAINAMIDE 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROCAINAMIDE 500MG/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROCAINAMIDE 500MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT ![Compare how all Medicare Part D PDP plans in KS cover PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN ![Compare how all Medicare Part D PDP plans in KS cover PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROCHLORPERAZINE MALEATE 25MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in KS cover PROCHLORPERAZINE MALEATE 25MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | 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 KS cover PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PROCRIT 20000U/ML VIAL MDV ![Compare how all Medicare Part D PDP plans in KS cover PROCRIT 20000U/ML VIAL MDV.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PROCRIT 3000U/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROCRIT 3000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in KS cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PROCRIT 4000U/ML VIAL 25 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROCRIT 4000U/ML VIAL 25 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PROCTO-PAK 1% CREAM ![Compare how all Medicare Part D PDP plans in KS cover PROCTO-PAK 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROCTOCREAM-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in KS cover PROCTOCREAM-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in KS cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in KS cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROGLYCEM 50MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in KS cover PROGLYCEM 50MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PROGRAF 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PROGRAF 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | P |
PROGRAF 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PROGRAF 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | P |
PROGRAF 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PROGRAF 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | P |
PROGRAF 5MG/ML AMPULE ![Compare how all Medicare Part D PDP plans in KS cover PROGRAF 5MG/ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PROLASTIN 1000MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROLASTIN 1000MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROLASTIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROLASTIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROLEUKIN 22 MILLION UNITS VL ![Compare how all Medicare Part D PDP plans in KS cover PROLEUKIN 22 MILLION UNITS VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | None |
PROMACTA TABLETS ![Compare how all Medicare Part D PDP plans in KS cover PROMACTA TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PROMACTA TABLETS 25 MG ![Compare how all Medicare Part D PDP plans in KS cover PROMACTA TABLETS 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5. |
33% | N/A | P |
PROMETHAZINE 50MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE 50MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHAZINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROMETHAZINE HCL 12.5MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 12.5MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL 25MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 25MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL 50MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 50MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL 6.25MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL 6.25MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROMETHAZINE SYRUP PLAIN 6.25MG 16 FL OZ BOT ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE SYRUP PLAIN 6.25MG 16 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHAZINE VC PLAIN 6.25-5MG 16 FL OZ BOT ![Compare how all Medicare Part D PDP plans in KS cover PROMETHAZINE VC PLAIN 6.25-5MG 16 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHEGAN 12.5MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in KS cover PROMETHEGAN 12.5MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in KS cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in KS cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROMETRIUM 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PROMETRIUM 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PROMETRIUM 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover PROMETRIUM 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PROPAFENONE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPAFENONE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPAFENONE HCL 300MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPAFENONE HCL 300MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPANTHELINE 15MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPANTHELINE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPARACAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in KS cover PROPARACAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPOXY-N/APAP 100-500MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPOXY-N/APAP 100-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:240 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPOXY-N/APAP 100-650 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPOXY-N/APAP 100-650 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:180 /30Days |
PROPOXY-N/APAP 50-325 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPOXY-N/APAP 50-325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:360 /30Days |
PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:210 /30Days |
PROPOXYPHENE HCL CAPSULES 65MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPOXYPHENE HCL CAPSULES 65MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL 60MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL HCL 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL HCL CAPSULES ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL CAPSULES ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
PROPRANOLOL HCL TABLET USP 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL TABLET USP 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL HCL TABLET USP 40MG (1000 CT) ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL HCL TABLET USP 40MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | None |
PROSOL 20% INJECTION ![Compare how all Medicare Part D PDP plans in KS cover PROSOL 20% INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | P |
PROTONIX IV 40MG VIAL ![Compare how all Medicare Part D PDP plans in KS cover PROTONIX IV 40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Non-Specialty Injectable |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROTRIPTYLINE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in KS cover PROTRIPTYLINE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:180 /30Days |
PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG ![Compare how all Medicare Part D PDP plans in KS cover PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | Q:120 /30Days |
PROVENTIL HFA INHALER 90MCG AE ![Compare how all Medicare Part D PDP plans in KS cover PROVENTIL HFA INHALER 90MCG AE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | Q:21 /30Days |
PROVIGIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROVIGIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | P Q:30 /30Days |
PROVIGIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PROVIGIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Preferred Brand |
$35.00 | $87.50 | P Q:60 /30Days |
PULMICORT .25MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in KS cover PULMICORT .25MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:120 /30Days |
PULMICORT 0.5MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in KS cover PULMICORT 0.5MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:120 /30Days |
PULMICORT 1MG/2ML AMPUL FOR NEBULIZATION ![Compare how all Medicare Part D PDP plans in KS cover PULMICORT 1MG/2ML AMPUL FOR NEBULIZATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Non-Preferred Brand or Generic |
$75.00 | $187.50 | Q:120 /30Days |
PYRAZINAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PYRAZINAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |
PYRIDOSTIGMINE BROMIDE 60MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover PYRIDOSTIGMINE BROMIDE 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$9.00 | $13.50 | None |