2010 Medicare Part D Plan Formulary Information |
PriorityMedicare Choice (PPO) (H4875-005-0)
Benefit Details
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The PriorityMedicare Choice (PPO) (H4875-005-0) Formulary Drugs Starting with the Letter P in Statewide County, MI: CMS MA Region 11 which includes: MI
|
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 MI cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PACERONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PACERONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PACERONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PACERONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD ![Compare how all Medicare Part D PDP plans in MI cover PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAMIDRONATE 60MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PAMIDRONATE 60MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in MI cover PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in MI cover PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PANCREASE MT 4 CAPSULE EC ![Compare how all Medicare Part D PDP plans in MI cover PANCREASE MT 4 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PANCRECARB MS-16 52-16-52 CAPSULE DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover PANCRECARB MS-16 52-16-52 CAPSULE DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PANCRECARB MS-4 CAPSULE EC ![Compare how all Medicare Part D PDP plans in MI cover PANCRECARB MS-4 CAPSULE EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANCRECARB MS-8 PANCRELIPASE CAPSULES 40000UNT (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PANCRECARB MS-8 PANCRELIPASE CAPSULES 40000UNT (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in MI cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | None |
PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover PANTOPRAZOLE SODIUM 20MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT ![Compare how all Medicare Part D PDP plans in MI cover PANTOPRAZOLE SODIUM 40MG TABLET DELAYED RELEASE 90 CRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROMOMYCIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PAROMOMYCIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROXETINE 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROXETINE FILM COATED 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE FILM COATED 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROXETINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROXETINE HCL 10MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL 10MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROXETINE HCL TABLET 24 12.5MG ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL TABLET 24 12.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PAROXETINE HCL TABLET 24 25MG ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL TABLET 24 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE TABLETS 30MG 90 BOT ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE TABLETS 30MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in MI cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PATADAY 0.2% DROPS ![Compare how all Medicare Part D PDP plans in MI cover PATADAY 0.2% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | S |
PATANOL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover PATANOL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | S |
PCE 333MG DISPERTAB ![Compare how all Medicare Part D PDP plans in MI cover PCE 333MG DISPERTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PCE 500MG DISPERTAB ![Compare how all Medicare Part D PDP plans in MI cover PCE 500MG DISPERTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PEDIARIX SOLUTION INJECTION 25-25-10 10 X .5ML VIAL ![Compare how all Medicare Part D PDP plans in MI 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 |
$30.00 | $75.00 | None |
PEDIOTIC EAR SUSPENSION ![Compare how all Medicare Part D PDP plans in MI cover PEDIOTIC EAR SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in MI cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL ![Compare how all Medicare Part D PDP plans in MI cover PEG 3350/ELECTROLYTE 240-22.72G SOLUTION RECONSTITUTED ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PEG-INTRON REDIPEN 120MCG ![Compare how all Medicare Part D PDP plans in MI cover PEG-INTRON REDIPEN 120MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEGANONE 250MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PEGANONE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PEGASYS 180MCG/0.5ML CONV.PK ![Compare how all Medicare Part D PDP plans in MI cover PEGASYS 180MCG/0.5ML CONV.PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | None |
PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENICILLIN G POTASSIUM FOR INJECTION ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G POTASSIUM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G SODIUM FOR INJECTION 5000000UNT 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENICILLIN V POTASSIUM 250MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN V POTASSIUM 250MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN V POTASSIUM FOR ORAL SOLUTION CONCENTRATE 125MG 200ML BOT ![Compare how all Medicare Part D PDP plans in MI 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 |
$8.00 | $20.00 | None |
PENTAM 300 INJ 300MG ![Compare how all Medicare Part D PDP plans in MI cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MI cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PENTAZOCINE/ACETAMIN TABLET ![Compare how all Medicare Part D PDP plans in MI cover PENTAZOCINE/ACETAMIN TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PENTAZOCINE/NALOXONE TABLET ![Compare how all Medicare Part D PDP plans in MI cover PENTAZOCINE/NALOXONE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PENTOXIL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover PENTOXIL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PERMETHRIN 5% CREAM ![Compare how all Medicare Part D PDP plans in MI cover PERMETHRIN 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PERPHENAZINE TABLETS 16MG 100 BOT ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE TABLETS 16MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PERPHENAZINE TABLETS 4MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE TABLETS 4MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERPHENAZINE TABLETS 8MG 100 BOT ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE TABLETS 8MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PERPHENAZINE TABLETS USP 2MG 100 BOT ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE TABLETS USP 2MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PHENYTEK 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PHENYTEK 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PHENYTEK 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PHENYTEK 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN SODIUM INJECTION 50MG 25 X 2ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PHISOHEX 3% CLEANSER ![Compare how all Medicare Part D PDP plans in MI cover PHISOHEX 3% CLEANSER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PHOSPHOLINE IODIDE 0.125% ![Compare how all Medicare Part D PDP plans in MI cover PHOSPHOLINE IODIDE 0.125%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PILOCARPINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PILOCARPINE HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PILOPINE HS 4% EYE GEL ![Compare how all Medicare Part D PDP plans in MI cover PILOPINE HS 4% EYE GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PINDOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PINDOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PINDOLOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PINDOLOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PIPERACILLIN 3GM VIAL ![Compare how all Medicare Part D PDP plans in MI cover PIPERACILLIN 3GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PIPERACILLIN 40GM BULK VIAL ![Compare how all Medicare Part D PDP plans in MI cover PIPERACILLIN 40GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PIROXICAM 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PIROXICAM 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PIROXICAM 20MG CAPSULE (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover PIROXICAM 20MG CAPSULE (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PLAVIX 75MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PLAVIX 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POLY-DEX 3.5-10K-.1 OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover POLY-DEX 3.5-10K-.1 OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POLY-PRED EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover POLY-PRED EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POLYCIN-B 500-10KU/G OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover POLYCIN-B 500-10KU/G OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POLYGAM S/D 10GM VL W/DILUENT ![Compare how all Medicare Part D PDP plans in MI cover POLYGAM S/D 10GM VL W/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in MI cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PONSTEL 250MG KAPSEALS ![Compare how all Medicare Part D PDP plans in MI cover PONSTEL 250MG KAPSEALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2% ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POTASSIUM CHLORIDE 10MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 10MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 20MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 20MEQ TABLET SR PARTICLES/CRYSTALS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 20MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE 30MEQ/100ML SOL ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 30MEQ/100ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 40MEQ IN D5W LACT RNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE 8MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE 8MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POTASSIUM CHLORIDE ER CAPSULES 10MEQ ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE ER CAPSULES 10MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POTASSIUM CHLORIDE ER CPCR 8MEQ ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE ER CPCR 8MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE FOR INJECTION CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE IN 5% DEXTROSE INJECTION 40 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in MI 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 |
$8.00 | $20.00 | P |
POTASSIUM CHLORIDE IN DEXTROSE AND SODIUM CHLORIDE INJECTION 5-30-.225 12 X 1000ML CTR ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CHLORIDE IN DEXTROSE AND SODIUM CHLORIDE INJECTION 5-30-.225 12 X 1000ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
POTASSIUM CITRATE 10MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CITRATE 10MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
POTASSIUM CITRATE 5MEQ TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CITRATE 5MEQ TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRANDIMET TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRANDIMET TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRANDIMET TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRANDIMET TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PRANDIN 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRANDIN 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PRANDIN 1MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRANDIN 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PRANDIN 2MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRANDIN 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PRAVASTATIN SODIUM 20MG TABLET 500 BOT ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 20MG TABLET 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRAVASTATIN SODIUM 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRAVASTATIN SODIUM 80MG TABLET (90 CT) ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 80MG TABLET (90 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRAVASTATIN SODIUM TABLETS 10MG 90 BOT ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM TABLETS 10MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in MI 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 |
$60.00 | $150.00 | None |
PRED MILD 0.12% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover PRED MILD 0.12% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PRED-G S.O.P. EYE OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover PRED-G S.O.P. EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREDNICARBATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in MI cover PREDNICARBATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISOLONE 5MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE 5MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PREMARIN 0.3MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PREMARIN 0.3MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMARIN 0.625MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PREMARIN 0.625MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMARIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMARIN 1.25MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PREMARIN 1.25MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMARIN VAGINAL CREAM /APPL ![Compare how all Medicare Part D PDP plans in MI cover PREMARIN VAGINAL CREAM /APPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PREMPHASE 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREMPHASE 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMPRO 0.3MG/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREMPRO 0.3MG/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMPRO 0.45/1.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREMPRO 0.45/1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMPRO 0.625/2.5MG TABLET DIALPK ![Compare how all Medicare Part D PDP plans in MI cover PREMPRO 0.625/2.5MG TABLET DIALPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREMPRO 0.625/5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREMPRO 0.625/5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PRENATABS OBN TABLETS 200;1;150;MG;MG;MCG; 90 BOT ![Compare how all Medicare Part D PDP plans in MI 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 |
$8.00 | $20.00 | None |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREZISTA TABLETS 400MG 60 TABLETS BOT ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA TABLETS 400MG 60 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PRIFTIN 150MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRIFTIN 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PRIMAQUINE 26.3MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRIMAQUINE 26.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRIMAXIN I.M. 500MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover PRIMAXIN I.M. 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | P |
PRIMAXIN IV 250MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover PRIMAXIN IV 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PRIMAXIN IV INJ 500MG ![Compare how all Medicare Part D PDP plans in MI cover PRIMAXIN IV INJ 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PRIMIDONE 250MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PRIMIDONE 250MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRIMIDONE 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover PRIMIDONE 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PRIMSOL 50MG/5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PRIMSOL 50MG/5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PRISTIQ 100MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MI cover PRISTIQ 100MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | S |
PRISTIQ 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MI cover PRISTIQ 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in MI cover PROAIR HFA 90MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROBENECID 500MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROBENECID 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROBENECID/COLCHICINE TABLET S ![Compare how all Medicare Part D PDP plans in MI cover PROBENECID/COLCHICINE TABLET S.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT ![Compare how all Medicare Part D PDP plans in MI cover PROCALAMINE INJECTION 210MG-290MG-26MG 6 X 1000ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROCHIEVE 4% GEL ![Compare how all Medicare Part D PDP plans in MI cover PROCHIEVE 4% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$60.00 | $150.00 | None |
PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE EDISYLATE INJECTION 10MG 10 X 2ML VIALS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE MALEATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCRIT 3000U/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 3000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
PROCRIT 4000U/ML VIAL 25 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 4000U/ML VIAL 25 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in MI 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 |
25% | N/A | P |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in MI cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROGLYCEM 50MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MI cover PROGLYCEM 50MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROGRAF 0.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROGRAF 0.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROGRAF 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROGRAF 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROGRAF 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROGRAF 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PROLASTIN 500MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROLASTIN 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
PROLEUKIN 22 MILLION UNITS VL ![Compare how all Medicare Part D PDP plans in MI cover PROLEUKIN 22 MILLION UNITS VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMACTA TABLETS ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
PROMACTA TABLETS 25 MG ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA TABLETS 25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
PROMETHAZINE HCL 12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HCL 12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHAZINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHAZINE HCL 6.25MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HCL 6.25MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HCL INJECTION 25MG 10 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in MI cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in MI cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETRIUM 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROMETRIUM 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROMETRIUM 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROMETRIUM 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROPAFENONE HCL 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPAFENONE HCL 300MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL 300MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPANTHELINE 15MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPANTHELINE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPARACAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover PROPARACAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPOXY-N/APAP 100-500MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPOXY-N/APAP 100-500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPOXY-N/APAP 100-650 TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPOXY-N/APAP 100-650 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPOXY-N/APAP 50-325 TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPOXY-N/APAP 50-325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPOXYPHENE HCL AND ACETAMINOPHEN TABLET 650/65MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPOXYPHENE HCL CAPSULES 65MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPOXYPHENE HCL CAPSULES 65MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL 60MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL 80MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL CAPSULES ER 120MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL CAPSULES ER 160MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL CAPSULES ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL CAPSULES ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL CAPSULES ER 80MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL INJECTION 1MG 10 PKG OF 10 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL HCL TABLET USP 10MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL TABLET USP 10MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL HCL TABLET USP 40MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL HCL TABLET USP 40MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROTOPIC 0.03% OINTMENT 100GM TUBE ![Compare how all Medicare Part D PDP plans in MI cover PROTOPIC 0.03% OINTMENT 100GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROTOPIC 0.1% OINTMENT 60GM TUBE ![Compare how all Medicare Part D PDP plans in MI cover PROTOPIC 0.1% OINTMENT 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PROTRIPTYLINE HYDROCHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in MI cover PROTRIPTYLINE HYDROCHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG ![Compare how all Medicare Part D PDP plans in MI cover PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PROVIGIL 100MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROVIGIL 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROVIGIL 200MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROVIGIL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PULMICORT .25MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in MI cover PULMICORT .25MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PULMICORT 0.5MG/2ML RESPULE ![Compare how all Medicare Part D PDP plans in MI cover PULMICORT 0.5MG/2ML RESPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | P |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in MI cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in MI cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$30.00 | $75.00 | None |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in MI cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | N/A | P |
PYRAZINAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PYRAZINAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |
PYRIDOSTIGMINE BROMIDE 60MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PYRIDOSTIGMINE BROMIDE 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$8.00 | $20.00 | None |