2010 Medicare Part D Plan Formulary Information |
FreedomBlue PPO HD Rx (PPO) (H3916-025-0)
Benefit Details
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The FreedomBlue PPO HD Rx (PPO) (H3916-025-0) Formulary Drugs Starting with the Letter P in Fulto County, PA: CMS MA Region 6 which includes: PA
|
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 PA cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PACERONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PACERONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PACERONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PACERONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PACERONE 400MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PACERONE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD ![Compare how all Medicare Part D PDP plans in PA cover PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PALGIC 4MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in PA cover PALGIC 4MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PALGIC TABLETS 4GM 100 CTR ![Compare how all Medicare Part D PDP plans in PA cover PALGIC TABLETS 4GM 100 CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMELOR 10MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in PA cover PAMELOR 10MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMELOR 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PAMELOR 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMELOR 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PAMELOR 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAMELOR CAPSULES 10 ![Compare how all Medicare Part D PDP plans in PA cover PAMELOR CAPSULES 10.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMELOR CAPSULES 75MG ![Compare how all Medicare Part D PDP plans in PA cover PAMELOR CAPSULES 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMIDRONATE 60MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PAMIDRONATE 60MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAMINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAMINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAMINE FORTE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAMINE FORTE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PANCREASE MT 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in PA cover PANCREASE MT 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PANCREASE MT 16 CAPSULE EC ![Compare how all Medicare Part D PDP plans in PA cover PANCREASE MT 16 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PANCREASE MT 20 CAPSULE EC ![Compare how all Medicare Part D PDP plans in PA cover PANCREASE MT 20 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PANCREASE MT 4 CAPSULE EC ![Compare how all Medicare Part D PDP plans in PA cover PANCREASE MT 4 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANCRECARB MS-16 52-16-52 CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in PA cover PANCRECARB MS-16 52-16-52 CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PANCRECARB MS-4 CAPSULE EC ![Compare how all Medicare Part D PDP plans in PA cover PANCRECARB MS-4 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PANCRECARB MS-8 PANCRELIPASE CAPSULES 40000UNT (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PANCRECARB MS-8 PANCRELIPASE CAPSULES 40000UNT (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PANCRELIPASE 16-48-48 CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PANCRELIPASE 16-48-48 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PANCRELIPASE TABLET 8000;30000 MG; ![Compare how all Medicare Part D PDP plans in PA cover PANCRELIPASE TABLET 8000;30000 MG;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PANCRON 10 CAPSULE EC ![Compare how all Medicare Part D PDP plans in PA cover PANCRON 10 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PANCRON 20 CAPSULE SA ![Compare how all Medicare Part D PDP plans in PA cover PANCRON 20 CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PANDEL 0.1% CREAM45GM ![Compare how all Medicare Part D PDP plans in PA cover PANDEL 0.1% CREAM45GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PANLOR DC CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PANLOR DC CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in PA cover PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT ![Compare how all Medicare Part D PDP plans in PA cover PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PARAFON FORTE DSC 500MG CPT ![Compare how all Medicare Part D PDP plans in PA cover PARAFON FORTE DSC 500MG CPT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PARCAINE 0.5% DROPS ![Compare how all Medicare Part D PDP plans in PA cover PARCAINE 0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PARCOPA 10MG/100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PARCOPA 10MG/100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PARCOPA 25MG/100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PARCOPA 25MG/100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PARCOPA 25MG/250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PARCOPA 25MG/250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PARLODEL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PARLODEL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PARLODEL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PARLODEL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PARNATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PARNATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAROMOMYCIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PAROMOMYCIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAROXETINE 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover PAROXETINE 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | 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 PA cover PAROXETINE FILM COATED 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAROXETINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAROXETINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAROXETINE HCL 10MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in PA cover PAROXETINE HCL 10MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAROXETINE HCL TABLET 24 12.5MG ![Compare how all Medicare Part D PDP plans in PA cover PAROXETINE HCL TABLET 24 12.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAROXETINE HCL TABLET 24 25MG ![Compare how all Medicare Part D PDP plans in PA cover PAROXETINE HCL TABLET 24 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PAROXETINE TABLETS 30MG 90 BOT ![Compare how all Medicare Part D PDP plans in PA cover PAROXETINE TABLETS 30MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in PA cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PATADAY 0.2% DROPS ![Compare how all Medicare Part D PDP plans in PA cover PATADAY 0.2% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PATANOL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover PATANOL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PAXIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAXIL 10MG/5ML SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover PAXIL 10MG/5ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAXIL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAXIL 30MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAXIL 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAXIL CR 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL CR 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAXIL CR 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL CR 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PAXIL CR 37.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PAXIL CR 37.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PCE 333MG DISPERTAB ![Compare how all Medicare Part D PDP plans in PA cover PCE 333MG DISPERTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PCE 500MG DISPERTAB ![Compare how all Medicare Part D PDP plans in PA cover PCE 500MG DISPERTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEDI-DRI TOPICAL POWDER ![Compare how all Medicare Part D PDP plans in PA cover PEDI-DRI TOPICAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PEDIAPRED 6.7MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover PEDIAPRED 6.7MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL ![Compare how all Medicare Part D PDP plans in PA 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 |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEDIOTIC EAR SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover PEDIOTIC EAR SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in PA cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in PA cover PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PEG-INTRON 100MCG KIT ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON 100MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEG-INTRON REDIPEN 120MCG ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON REDIPEN 120MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEG-INTRON REDIPEN 150MCG ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON REDIPEN 150MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEG-INTRON REDIPEN 50MCG ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON REDIPEN 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEG-INTRON REDIPEN 80MCG ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON REDIPEN 80MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEG-INTRON REDIPEN 80MCG 4PK ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON REDIPEN 80MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEG-INTRON REDIPEN PAK 4 ![Compare how all Medicare Part D PDP plans in PA cover PEG-INTRON REDIPEN PAK 4.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEGANONE 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEGANONE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | 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 PA cover PEGASYS 180MCG/0.5ML CONV.PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PEGINTRON REDIPEN 150MCG 4PK ![Compare how all Medicare Part D PDP plans in PA cover PEGINTRON REDIPEN 150MCG 4PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PENICILLIN V POTASSIUM 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN V POTASSIUM 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in PA 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 |
$7.00 | $17.50 | None |
PENLAC 8% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PENLAC 8% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PENTAM 300 INJ 300MG ![Compare how all Medicare Part D PDP plans in PA cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PA cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PENTAZOCINE/ACETAMIN TABLET ![Compare how all Medicare Part D PDP plans in PA cover PENTAZOCINE/ACETAMIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENTAZOCINE/NALOXONE TABLET ![Compare how all Medicare Part D PDP plans in PA cover PENTAZOCINE/NALOXONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENTOPAK 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover PENTOPAK 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENTOSTATIN FOR INJECTION 10MG/VIAL ![Compare how all Medicare Part D PDP plans in PA cover PENTOSTATIN FOR INJECTION 10MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PENTOXIL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover PENTOXIL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEPCID 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEPCID 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEPCID 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEPCID 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEPCID IV INJECTION 10MG/ML 10X2ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover PEPCID IV INJECTION 10MG/ML 10X2ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEPCID PREMX SOL 20MG/50M ![Compare how all Medicare Part D PDP plans in PA cover PEPCID PREMX SOL 20MG/50M.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEPCID SOLUTION 40MG 24 X 400MG BOT ![Compare how all Medicare Part D PDP plans in PA cover PEPCID SOLUTION 40MG 24 X 400MG BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERCOCET 10/325MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERCOCET 10/325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERCOCET 10/650MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERCOCET 10/650MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERCOCET 2.5/325MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERCOCET 2.5/325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERCOCET 7.5/325MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERCOCET 7.5/325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERCOCET 7.5/500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERCOCET 7.5/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERCOCET TABLET 5-325MG ![Compare how all Medicare Part D PDP plans in PA cover PERCOCET TABLET 5-325MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERCODAN TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERCODAN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERFOROMIST 20MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in PA cover PERFOROMIST 20MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Peridex 0.12% Solution 473ml Bottle ![Compare how all Medicare Part D PDP plans in PA cover Peridex 0.12% Solution 473ml Bottle.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERIOGARD 0.12% ORAL RINSE ![Compare how all Medicare Part D PDP plans in PA cover PERIOGARD 0.12% ORAL RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PERIOSTAT DOXYCYCLINE HYCLATE TABLETS 20MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover PERIOSTAT DOXYCYCLINE HYCLATE TABLETS 20MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERMETHRIN 5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PERMETHRIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PERPHENAZINE TABLETS 16MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover PERPHENAZINE TABLETS 16MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PERPHENAZINE TABLETS 4MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in PA cover PERPHENAZINE TABLETS 4MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PERPHENAZINE TABLETS 8MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover PERPHENAZINE TABLETS 8MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PERPHENAZINE TABLETS USP 2MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover PERPHENAZINE TABLETS USP 2MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PERSANTINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERSANTINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERSANTINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERSANTINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PERSANTINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PERSANTINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEXEVA 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEXEVA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEXEVA 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEXEVA 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEXEVA 30MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEXEVA 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PEXEVA 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PEXEVA 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PFIZERPEN 20MMU VIAL ![Compare how all Medicare Part D PDP plans in PA cover PFIZERPEN 20MMU VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PFIZERPEN 5MMU VIAL ![Compare how all Medicare Part D PDP plans in PA cover PFIZERPEN 5MMU VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PHENADOZ 12.5MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in PA cover PHENADOZ 12.5MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PHENADOZ 25MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in PA cover PHENADOZ 25MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PHENERGAN 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PHENERGAN 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENERGAN 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PHENERGAN 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PHENYTEK 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PHENYTEK 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PHENYTEK 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PHENYTEK 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in PA cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP ![Compare how all Medicare Part D PDP plans in PA cover PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PHISOHEX 3% CLEANSER ![Compare how all Medicare Part D PDP plans in PA cover PHISOHEX 3% CLEANSER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PHOSLO 667MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PHOSLO 667MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PHOSPHOLINE IODIDE 0.125% ![Compare how all Medicare Part D PDP plans in PA cover PHOSPHOLINE IODIDE 0.125%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PHOTOFRIN 75MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover PHOTOFRIN 75MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PHYSIOLYTE SOLUTION FOR IRRIGATION ![Compare how all Medicare Part D PDP plans in PA cover PHYSIOLYTE SOLUTION FOR IRRIGATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHYSIOSOL IRRIGATION SOL ![Compare how all Medicare Part D PDP plans in PA cover PHYSIOSOL IRRIGATION SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PILOCARPINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PILOCARPINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PILOCARPINE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PILOCARPINE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PILOPINE HS 4% EYE GEL ![Compare how all Medicare Part D PDP plans in PA cover PILOPINE HS 4% EYE GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PINDOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PINDOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PINDOLOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PINDOLOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PIPERACILLIN 3GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover PIPERACILLIN 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PIPERACILLIN 40GM BULK VIAL ![Compare how all Medicare Part D PDP plans in PA cover PIPERACILLIN 40GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PIROXICAM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PIROXICAM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PIROXICAM 20MG CAPSULE (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover PIROXICAM 20MG CAPSULE (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PLAN B 0.75MG TABLET 2 BLPK ![Compare how all Medicare Part D PDP plans in PA cover PLAN B 0.75MG TABLET 2 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PLAQUENIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PLAQUENIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PLASMA-LYTE 148 IV SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PLASMA-LYTE 148 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PLASMA-LYTE 148/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in PA cover PLASMA-LYTE 148/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PLASMA-LYTE 56 INJECTION 32;128 MG/100ML; ![Compare how all Medicare Part D PDP plans in PA cover PLASMA-LYTE 56 INJECTION 32;128 MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PLASMA-LYTE 56/DEXTROSE 5% ![Compare how all Medicare Part D PDP plans in PA cover PLASMA-LYTE 56/DEXTROSE 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML; ![Compare how all Medicare Part D PDP plans in PA cover PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PLASMA-LYTE INJ-R ![Compare how all Medicare Part D PDP plans in PA cover PLASMA-LYTE INJ-R.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | P |
PLATINOL AQ INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PLATINOL AQ INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PLAVIX 75MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PLAVIX 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PLAVIX TABLETS 300MG ![Compare how all Medicare Part D PDP plans in PA cover PLAVIX TABLETS 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PLETAL 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PLETAL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PLETAL 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PLETAL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in PA cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POLY-DEX 0.1% SUSPENSION DROPS ![Compare how all Medicare Part D PDP plans in PA cover POLY-DEX 0.1% SUSPENSION DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POLY-DEX 3.5-10K-.1 OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover POLY-DEX 3.5-10K-.1 OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POLY-PRED EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover POLY-PRED EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
POLYCIN-B 500-10KU/G OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover POLYCIN-B 500-10KU/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POLYGAM S/D 10GM VL W/DILUENT ![Compare how all Medicare Part D PDP plans in PA cover POLYGAM S/D 10GM VL W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in PA cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POLYMYXIN B SULFATE VIAL ![Compare how all Medicare Part D PDP plans in PA cover POLYMYXIN B SULFATE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POLYTRIM EYE DROP ![Compare how all Medicare Part D PDP plans in PA cover POLYTRIM EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PONSTEL 250MG KAPSEALS ![Compare how all Medicare Part D PDP plans in PA cover PONSTEL 250MG KAPSEALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3% ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45% ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 10MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 10MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 10MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 10MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225% ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 20MEQ/50ML SOL ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 20MEQ/50ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
POTASSIUM CHLORIDE 30MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 30MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9% ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE ER CAPSULES 10MEQ ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE ER CAPSULES 10MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE ER CPCR 8MEQ ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE ER CPCR 8MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
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 PA 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) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND NACL SOLUTION FOR INJECTION 0.075% 1000ML PLASTIC BAGS X 12 CA ![Compare how all Medicare Part D PDP plans in PA 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 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | 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 PA 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) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CHLORIDE IN DEXTROSE INJECTION 5GM/75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION 0.15%-0.9% 12 X 1000ML BAG ![Compare how all Medicare Part D PDP plans in PA 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 |
Tier 1 |
$7.00 | $17.50 | None |
POTASSIUM CITRATE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CITRATE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CITRATE 5MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover POTASSIUM CITRATE 5MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRANDIMET TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRANDIMET TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRANDIMET TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRANDIMET TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRANDIN 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRANDIN 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRANDIN 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRANDIN 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRANDIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRANDIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRAVACHOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRAVACHOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRAVACHOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRAVACHOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRAVACHOL 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRAVACHOL 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRAVACHOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRAVACHOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRAVASTATIN SODIUM 20MG TABLET 500 BOT ![Compare how all Medicare Part D PDP plans in PA cover PRAVASTATIN SODIUM 20MG TABLET 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAVASTATIN SODIUM 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover PRAVASTATIN SODIUM 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRAVASTATIN SODIUM 80MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in PA cover PRAVASTATIN SODIUM 80MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRAVASTATIN SODIUM TABLETS 10MG 90 BOT ![Compare how all Medicare Part D PDP plans in PA cover PRAVASTATIN SODIUM TABLETS 10MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PRAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PRAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRECOSE TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover PRECOSE TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRECOSE TABLETS 25MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover PRECOSE TABLETS 25MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRECOSE TABLETS 50MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in PA cover PRECOSE TABLETS 50MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRED FORTE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover PRED FORTE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in PA cover PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRED MILD 0.12% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover PRED MILD 0.12% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRED-G S.O.P. EYE OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover PRED-G S.O.P. EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREDNICARBATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PREDNICARBATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISOLONE 5MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover PREDNISOLONE 5MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR ![Compare how all Medicare Part D PDP plans in PA cover PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in PA cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in PA cover PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREFEST TABLET 30 EA ![Compare how all Medicare Part D PDP plans in PA cover PREFEST TABLET 30 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREGNYL INJ 10000UNT ![Compare how all Medicare Part D PDP plans in PA cover PREGNYL INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PRELONE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in PA cover PRELONE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREMARIN 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PREMARIN 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMARIN 0.625MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PREMARIN 0.625MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | 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 PA cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMARIN 1.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PREMARIN 1.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMARIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover PREMARIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREMARIN VAGINAL CREAM /APPL ![Compare how all Medicare Part D PDP plans in PA cover PREMARIN VAGINAL CREAM /APPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | P |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
PREMPHASE 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREMPHASE 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMPRO 0.3MG/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREMPRO 0.3MG/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMPRO 0.45/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREMPRO 0.45/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMPRO 0.625/2.5MG TABLET DIALPK ![Compare how all Medicare Part D PDP plans in PA cover PREMPRO 0.625/2.5MG TABLET DIALPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREMPRO 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PREMPRO 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRENATABS OBN TABLETS 200;1;150;MG;MG;MCG; 90 BOT ![Compare how all Medicare Part D PDP plans in PA cover PRENATABS OBN TABLETS 200;1;150;MG;MG;MCG; 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREVACID CAPSULES EXTENDED RELEASE 15MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in PA cover PREVACID CAPSULES EXTENDED RELEASE 15MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREVACID CAPSULES EXTENDED RELEASE 30MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in PA cover PREVACID CAPSULES EXTENDED RELEASE 30MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREVACID NAP KIT 500MG ![Compare how all Medicare Part D PDP plans in PA cover PREVACID NAP KIT 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREVACID SOLUTAB EXTENDED RELEASE ORALLY DISINTEGRATING 30MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in PA cover PREVACID SOLUTAB EXTENDED RELEASE ORALLY DISINTEGRATING 30MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREVACID SOLUTAB TABLETS DELAYED RELEASE ORALLY DISINTEGRATING 15MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in PA cover PREVACID SOLUTAB TABLETS DELAYED RELEASE ORALLY DISINTEGRATING 15MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PREVALITE POW 4GM PK ![Compare how all Medicare Part D PDP plans in PA cover PREVALITE POW 4GM PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREVIFEM TABLETS .035;.25MG;MG 28 BLPK ![Compare how all Medicare Part D PDP plans in PA cover PREVIFEM TABLETS .035;.25MG;MG 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in PA cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in PA cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PREZISTA TABLETS 400MG 60 TABLETS BOT ![Compare how all Medicare Part D PDP plans in PA cover PREZISTA TABLETS 400MG 60 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRIFTIN 150MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRIFTIN 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRILOSEC 10MG CAPSULE DR ![Compare how all Medicare Part D PDP plans in PA cover PRILOSEC 10MG CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRILOSEC 20MG CAPSULE DR ![Compare how all Medicare Part D PDP plans in PA cover PRILOSEC 20MG CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRILOSEC 40MG CAPSULE DR ![Compare how all Medicare Part D PDP plans in PA cover PRILOSEC 40MG CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRIMAQUINE 26.3MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRIMAQUINE 26.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PRIMAXIN I.M. 500MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover PRIMAXIN I.M. 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRIMAXIN IV 250MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover PRIMAXIN IV 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in PA cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRIMIDONE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PRIMIDONE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRIMIDONE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover PRIMIDONE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PRIMSOL 50MG/5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PRIMSOL 50MG/5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRINIVIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRINIVIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRINIVIL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRINIVIL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRINIVIL 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRINIVIL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRINZIDE 10/12.5 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRINZIDE 10/12.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRINZIDE 20/12.5 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRINZIDE 20/12.5 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRINZIDE 20/25 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PRINZIDE 20/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRISTIQ 100MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PA cover PRISTIQ 100MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PRISTIQ 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PA cover PRISTIQ 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in PA cover PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROAMATINE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROAMATINE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROAMATINE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROAMATINE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROAMATINE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROAMATINE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROBENECID 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROBENECID 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROBENECID/COLCHICINE TABLET S ![Compare how all Medicare Part D PDP plans in PA cover PROBENECID/COLCHICINE TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCAINAMIDE 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROCAINAMIDE 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCAINAMIDE 500MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROCAINAMIDE 500MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT ![Compare how all Medicare Part D PDP plans in PA cover PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PROCARDIA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROCARDIA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCARDIA XL 30MG TABLET (300 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROCARDIA XL 30MG TABLET (300 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCARDIA XL 60MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover PROCARDIA XL 60MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCARDIA XL 90MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover PROCARDIA XL 90MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCHIEVE 4% GEL ![Compare how all Medicare Part D PDP plans in PA cover PROCHIEVE 4% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCHIEVE GEL 8% ![Compare how all Medicare Part D PDP plans in PA cover PROCHIEVE GEL 8%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN ![Compare how all Medicare Part D PDP plans in PA cover PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in PA cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROCRIT 3000U/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROCRIT 3000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in PA cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
PROCRIT 4000U/ML VIAL 25 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROCRIT 4000U/ML VIAL 25 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in PA cover PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCTO-PAK 1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PROCTO-PAK 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCTOCORT 1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PROCTOCORT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCTOCREAM-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PROCTOCREAM-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in PA cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROGLYCEM 50MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in PA cover PROGLYCEM 50MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROGRAF 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROGRAF 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
PROGRAF 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROGRAF 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
PROGRAF 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROGRAF 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PROGRAF 5MG/ML AMPULE ![Compare how all Medicare Part D PDP plans in PA cover PROGRAF 5MG/ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
PROLASTIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROLASTIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROLEUKIN 22 MILLION UNITS VL ![Compare how all Medicare Part D PDP plans in PA cover PROLEUKIN 22 MILLION UNITS VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
PROMACTA TABLETS ![Compare how all Medicare Part D PDP plans in PA cover PROMACTA TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PROMACTA TABLETS 25 MG ![Compare how all Medicare Part D PDP plans in PA cover PROMACTA TABLETS 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
PROMETHAZINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHAZINE HCL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HCL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHAZINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHAZINE HCL 6.25MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HCL 6.25MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in PA cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHAZINE VC PLAIN 6.25-5MG 16 FL OZ BOT ![Compare how all Medicare Part D PDP plans in PA 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 |
$7.00 | $17.50 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in PA cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in PA cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROMETRIUM 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROMETRIUM 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROMETRIUM 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROMETRIUM 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROPAFENONE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPAFENONE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPAFENONE HCL 300MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPAFENONE HCL 300MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPANTHELINE 15MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPANTHELINE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPARACAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover PROPARACAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPINE 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover PROPINE 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPOXY-N/APAP 100-500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPOXY-N/APAP 100-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPOXY-N/APAP 100-650 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPOXY-N/APAP 100-650 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPOXY-N/APAP 50-325 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPOXY-N/APAP 50-325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPOXYPHENE HCL CAPSULES 65MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPOXYPHENE HCL CAPSULES 65MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL 60MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL CAPSULES ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL CAPSULES ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL TABLET USP 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL TABLET USP 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL HCL TABLET USP 40MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL HCL TABLET USP 40MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
PROQUIN XR ER TABLET 582MG ![Compare how all Medicare Part D PDP plans in PA cover PROQUIN XR ER TABLET 582MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROSCAR TABLETS 5MG 30 BOT ![Compare how all Medicare Part D PDP plans in PA cover PROSCAR TABLETS 5MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROSOL 20% INJECTION ![Compare how all Medicare Part D PDP plans in PA cover PROSOL 20% INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTONIX 20MG TABLET EC ![Compare how all Medicare Part D PDP plans in PA cover PROTONIX 20MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTONIX 40MG SUSP FOR RECON DELAYED REL. IN A PACKET ![Compare how all Medicare Part D PDP plans in PA cover PROTONIX 40MG SUSP FOR RECON DELAYED REL. IN A PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTONIX 40MG TABLET EC ![Compare how all Medicare Part D PDP plans in PA cover PROTONIX 40MG TABLET EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTONIX IV 40MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover PROTONIX IV 40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTOPIC 0.03% OINTMENT 100GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover PROTOPIC 0.03% OINTMENT 100GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTOPIC 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover PROTOPIC 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROTRIPTYLINE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in PA cover PROTRIPTYLINE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG ![Compare how all Medicare Part D PDP plans in PA cover PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PROVENTIL HFA INHALER 90MCG AE ![Compare how all Medicare Part D PDP plans in PA cover PROVENTIL HFA INHALER 90MCG AE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROVERA 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROVERA 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROVERA 2.5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROVERA 2.5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROVERA 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROVERA 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROVIGIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROVIGIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
PROVIGIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROVIGIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$42.00 | $105.00 | P |
PROZAC 10MG PULVULE ![Compare how all Medicare Part D PDP plans in PA cover PROZAC 10MG PULVULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROZAC 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PROZAC 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROZAC 20MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover PROZAC 20MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROZAC 40MG PULVULE ![Compare how all Medicare Part D PDP plans in PA cover PROZAC 40MG PULVULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROZAC CAPSULES 20MG (2000 CT) ![Compare how all Medicare Part D PDP plans in PA cover PROZAC CAPSULES 20MG (2000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PROZAC WEEKLY 90MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PROZAC WEEKLY 90MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PULMICORT .25MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in PA cover PULMICORT .25MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PULMICORT 0.5MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in PA cover PULMICORT 0.5MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PULMICORT 1MG/2ML AMPUL FOR NEBULIZATION ![Compare how all Medicare Part D PDP plans in PA cover PULMICORT 1MG/2ML AMPUL FOR NEBULIZATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in PA cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in PA cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in PA cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | P |
PURINETHOL 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PURINETHOL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PYLERA 125-125MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover PYLERA 125-125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$90.00 | $225.00 | None |
PYRAZINAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PYRAZINAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |
PYRIDOSTIGMINE BROMIDE 60MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover PYRIDOSTIGMINE BROMIDE 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$7.00 | $17.50 | None |