2010 Medicare Part D Plan Formulary Information |
AdvantraRx Premier Plus (PDP) (S5674-029-0)
Benefit Details
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The AdvantraRx Premier Plus (PDP) (S5674-029-0) Formulary Drugs Starting with the Letter P in CMS PDP Region 15 which includes: IN KY
|
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 IN cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PACERONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PACERONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PACERONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PACERONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD ![Compare how all Medicare Part D PDP plans in IN cover PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P |
PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in IN cover PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P |
PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in IN cover PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PARCAINE 0.5% DROPS ![Compare how all Medicare Part D PDP plans in IN cover PARCAINE 0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PAROMOMYCIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PAROMOMYCIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PAROXETINE 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE FILM COATED 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE FILM COATED 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PAROXETINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PAROXETINE HCL 10MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL 10MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PAROXETINE HCL TABLET 24 12.5MG ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL TABLET 24 12.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
PAROXETINE HCL TABLET 24 25MG ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL TABLET 24 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:60 /30Days |
PAROXETINE TABLETS 30MG 90 BOT ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE TABLETS 30MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in IN cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PATADAY 0.2% DROPS ![Compare how all Medicare Part D PDP plans in IN cover PATADAY 0.2% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | Q:3 /30Days |
PATANOL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover PATANOL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PAXIL CR 37.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PAXIL CR 37.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:60 /30Days |
PCE 333MG DISPERTAB ![Compare how all Medicare Part D PDP plans in IN cover PCE 333MG DISPERTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PCE 500MG DISPERTAB ![Compare how all Medicare Part D PDP plans in IN cover PCE 500MG DISPERTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in IN cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in IN cover PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PEG-INTRON 100MCG KIT ![Compare how all Medicare Part D PDP plans in IN cover PEG-INTRON 100MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P S |
PEG-INTRON REDIPEN 120MCG ![Compare how all Medicare Part D PDP plans in IN cover PEG-INTRON REDIPEN 120MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P S Q:4 /30Days |
PEG-INTRON REDIPEN 150MCG ![Compare how all Medicare Part D PDP plans in IN cover PEG-INTRON REDIPEN 150MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P S Q:4 /30Days |
PEG-INTRON REDIPEN 80MCG ![Compare how all Medicare Part D PDP plans in IN cover PEG-INTRON REDIPEN 80MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P S Q:4 /30Days |
PEGANONE 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PEGANONE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PEGASYS 180MCG/0.5ML CONV.PK ![Compare how all Medicare Part D PDP plans in IN cover PEGASYS 180MCG/0.5ML CONV.PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P Q:1 /28Days |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PENICILLIN V POTASSIUM 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN V POTASSIUM 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PENTAZOCINE/ACETAMIN TABLET ![Compare how all Medicare Part D PDP plans in IN cover PENTAZOCINE/ACETAMIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PENTAZOCINE/NALOXONE TABLET ![Compare how all Medicare Part D PDP plans in IN cover PENTAZOCINE/NALOXONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PEPCID SOLUTION 40MG 24 X 400MG BOT ![Compare how all Medicare Part D PDP plans in IN cover PEPCID SOLUTION 40MG 24 X 400MG BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PERFOROMIST 20MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in IN cover PERFOROMIST 20MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P S Q:120 /30Days |
PERMETHRIN 5% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PERMETHRIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PERPHENAZINE TABLETS 16MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE TABLETS 16MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PERPHENAZINE TABLETS 4MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE TABLETS 4MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PERPHENAZINE TABLETS 8MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE TABLETS 8MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PERPHENAZINE TABLETS USP 2MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE TABLETS USP 2MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PHENYTEK 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PHENYTEK 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PHENYTEK 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PHENYTEK 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PHOSPHOLINE IODIDE 0.125% ![Compare how all Medicare Part D PDP plans in IN cover PHOSPHOLINE IODIDE 0.125%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PILOCARPINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PILOCARPINE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PILOPINE HS 4% EYE GEL ![Compare how all Medicare Part D PDP plans in IN cover PILOPINE HS 4% EYE GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PINDOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PINDOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PINDOLOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PINDOLOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PIPERACILLIN 3GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover PIPERACILLIN 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PIPERACILLIN 40GM BULK VIAL ![Compare how all Medicare Part D PDP plans in IN cover PIPERACILLIN 40GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PIROXICAM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PIROXICAM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIROXICAM 20MG CAPSULE (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover PIROXICAM 20MG CAPSULE (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PLAN B 0.75MG TABLET 2 BLPK ![Compare how all Medicare Part D PDP plans in IN cover PLAN B 0.75MG TABLET 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PLAVIX 75MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PLAVIX 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PLAVIX TABLETS 300MG ![Compare how all Medicare Part D PDP plans in IN cover PLAVIX TABLETS 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:1 /365Days |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
POLY-DEX 0.1% SUSPENSION DROPS ![Compare how all Medicare Part D PDP plans in IN cover POLY-DEX 0.1% SUSPENSION DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POLY-PRED EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover POLY-PRED EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
POLYGAM S/D 10GM VL W/DILUENT ![Compare how all Medicare Part D PDP plans in IN cover POLYGAM S/D 10GM VL W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in IN cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3% ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45% ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 10MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 10MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 10MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 10MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225% ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 20MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 20MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 30MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 30MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE ER CAPSULES 10MEQ ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE ER CAPSULES 10MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE ER CPCR 8MEQ ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE ER CPCR 8MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | 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 IN 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) |
1 |
Preferred Generic |
$5.00 | $12.50 | 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 IN 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) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | 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 IN 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) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION 0.15%-0.9% 12 X 1000ML BAG ![Compare how all Medicare Part D PDP plans in IN 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) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CITRATE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CITRATE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
POTASSIUM CITRATE 5MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CITRATE 5MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRAVASTATIN SODIUM 20MG TABLET 500 BOT ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 20MG TABLET 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRAVASTATIN SODIUM 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRAVASTATIN SODIUM 80MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 80MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRAVASTATIN SODIUM TABLETS 10MG 90 BOT ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM TABLETS 10MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in IN cover PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PRED MILD 0.12% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover PRED MILD 0.12% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PRED-G S.O.P. EYE OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover PRED-G S.O.P. EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PREDNICARBATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PREDNICARBATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISOLONE 5MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE 5MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PREFEST TABLET 30 EA ![Compare how all Medicare Part D PDP plans in IN cover PREFEST TABLET 30 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | Q:30 /30Days |
PREMARIN 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMARIN 0.625MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.625MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMARIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMARIN 1.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 1.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMARIN VAGINAL CREAM /APPL ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN VAGINAL CREAM /APPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PREMPHASE 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMPHASE 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMPRO 0.3MG/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.3MG/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMPRO 0.45/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.45/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMPRO 0.625/2.5MG TABLET DIALPK ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.625/2.5MG TABLET DIALPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PREMPRO 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PRENATABS OBN TABLETS 200;1;150;MG;MG;MCG; 90 BOT ![Compare how all Medicare Part D PDP plans in IN cover PRENATABS OBN TABLETS 200;1;150;MG;MG;MCG; 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | P |
PREVACID SOLUTAB EXTENDED RELEASE ORALLY DISINTEGRATING 30MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in IN cover PREVACID SOLUTAB EXTENDED RELEASE ORALLY DISINTEGRATING 30MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREVACID SOLUTAB TABLETS DELAYED RELEASE ORALLY DISINTEGRATING 15MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in IN cover PREVACID SOLUTAB TABLETS DELAYED RELEASE ORALLY DISINTEGRATING 15MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
PREVALITE POW 4GM PK ![Compare how all Medicare Part D PDP plans in IN cover PREVALITE POW 4GM PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PREZISTA TABLETS 400MG 60 TABLETS BOT ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA TABLETS 400MG 60 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | None |
PRIFTIN 150MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRIFTIN 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PRIMAQUINE 26.3MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRIMAQUINE 26.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PRIMAXIN I.M. 500MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover PRIMAXIN I.M. 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PRIMAXIN IV 250MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover PRIMAXIN IV 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in IN cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PRIMIDONE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PRIMIDONE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRIMIDONE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover PRIMIDONE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PRIMSOL 50MG/5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PRIMSOL 50MG/5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PRISTIQ 100MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IN cover PRISTIQ 100MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
PRISTIQ 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IN cover PRISTIQ 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in IN cover PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:17 /30Days |
PROBENECID 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROBENECID 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROBENECID/COLCHICINE TABLET S ![Compare how all Medicare Part D PDP plans in IN cover PROBENECID/COLCHICINE TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCAINAMIDE 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCAINAMIDE 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCAINAMIDE 500MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCAINAMIDE 500MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCHIEVE 4% GEL ![Compare how all Medicare Part D PDP plans in IN cover PROCHIEVE 4% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PROCHIEVE GEL 8% ![Compare how all Medicare Part D PDP plans in IN cover PROCHIEVE GEL 8%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P Q:12 /28Days |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P Q:12 /28Days |
PROCRIT 3000U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 3000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P Q:12 /28Days |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P Q:4 /28Days |
PROCRIT 4000U/ML VIAL 25 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 4000U/ML VIAL 25 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P Q:12 /28Days |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P Q:12 /28Days |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROGLYCEM 50MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover PROGLYCEM 50MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PROGRAF 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROGRAF 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P |
PROGRAF 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROGRAF 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P |
PROGRAF 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROGRAF 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P |
PROLASTIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROLASTIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P |
PROLEUKIN 22 MILLION UNITS VL ![Compare how all Medicare Part D PDP plans in IN cover PROLEUKIN 22 MILLION UNITS VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P |
PROMACTA TABLETS ![Compare how all Medicare Part D PDP plans in IN cover PROMACTA TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P Q:30 /30Days |
PROMACTA TABLETS 25 MG ![Compare how all Medicare Part D PDP plans in IN cover PROMACTA TABLETS 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P Q:30 /30Days |
PROMETHAZINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE HCL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HCL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE HCL 6.25MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HCL 6.25MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHAZINE VC PLAIN 6.25-5MG 16 FL OZ BOT ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE VC PLAIN 6.25-5MG 16 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in IN cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in IN cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROMETRIUM 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROMETRIUM 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
PROMETRIUM 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROMETRIUM 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPAFENONE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPAFENONE HCL 300MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL 300MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPANTHELINE 15MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPANTHELINE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPARACAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover PROPARACAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPOXY-N/APAP 100-500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPOXY-N/APAP 100-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PROPOXY-N/APAP 100-650 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPOXY-N/APAP 100-650 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPOXY-N/APAP 50-325 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPOXY-N/APAP 50-325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPOXYPHENE HCL CAPSULES 65MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPOXYPHENE HCL CAPSULES 65MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL 60MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL HCL 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPRANOLOL HCL CAPSULES ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL CAPSULES ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |
PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL HCL TABLET USP 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL TABLET USP 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL HCL TABLET USP 40MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL HCL TABLET USP 40MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PROTONIX 20MG TABLET EC ![Compare how all Medicare Part D PDP plans in IN cover PROTONIX 20MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PROTONIX 40MG TABLET EC ![Compare how all Medicare Part D PDP plans in IN cover PROTONIX 40MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
20% | 18% | Q:30 /30Days |
PROTONIX IV 40MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROTONIX IV 40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P |
PROTOPIC 0.03% OINTMENT 100GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover PROTOPIC 0.03% OINTMENT 100GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
PROTOPIC 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover PROTOPIC 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:30 /30Days |
PROTRIPTYLINE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in IN cover PROTRIPTYLINE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG ![Compare how all Medicare Part D PDP plans in IN cover PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROVENTIL HFA INHALER 90MCG AE ![Compare how all Medicare Part D PDP plans in IN cover PROVENTIL HFA INHALER 90MCG AE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | Q:13 /30Days |
PROVIGIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROVIGIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P Q:30 /30Days |
PROVIGIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROVIGIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | P Q:30 /30Days |
PROZAC WEEKLY 90MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROZAC WEEKLY 90MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | S Q:4 /28Days |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in IN cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | Q:2 /30Days |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in IN cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
75% | 75% | Q:2 /30Days |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IN cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty - Generic and Brand |
33% | N/A | P |
PYRAZINAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PYRAZINAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $12.50 | None |
PYRIDOSTIGMINE BROMIDE 60MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PYRIDOSTIGMINE BROMIDE 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generics |
$25.00 | $62.50 | None |