2011 Medicare Part D Plan Formulary Information |
Geisinger Gold Secure 3 (HMO SNP) (H3954-135-0)
Benefit Details
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The Geisinger Gold Secure 3 (HMO SNP) (H3954-135-0) Formulary Drugs Starting with the Letter M in Lackawanna County, PA: CMS MA Region 6 which includes: PA
|
Drugs Starting with Letter M
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML ![Compare how all Medicare Part D PDP plans in PA cover M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MAPROTILINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MAPROTILINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MAPROTILINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MARPLAN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MATULANE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MATULANE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
MAXALT 5MG TABLET 12 CRTN ![Compare how all Medicare Part D PDP plans in PA cover MAXALT 5MG TABLET 12 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | Q:6 /7Days |
MAXALT MLT 10MG TABLET 4X3 UNIT DOSE CASE ![Compare how all Medicare Part D PDP plans in PA cover MAXALT MLT 10MG TABLET 4X3 UNIT DOSE CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | Q:6 /15Days |
MAXALT MLT 5MG TABLET 4X3 UNIT CASE ![Compare how all Medicare Part D PDP plans in PA cover MAXALT MLT 5MG TABLET 4X3 UNIT CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | Q:6 /15Days |
MAXIPIME 1G VIAL ![Compare how all Medicare Part D PDP plans in PA cover MAXIPIME 1G VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MAXIPIME 2G ADD-VANTAGE VL ![Compare how all Medicare Part D PDP plans in PA cover MAXIPIME 2G ADD-VANTAGE VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MEBENDAZOLE 100MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in PA cover MEBENDAZOLE 100MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MECLIZINE HYDROCHLORIDE TABLETS 12.5MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover MECLIZINE HYDROCHLORIDE TABLETS 12.5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MECLIZINE HYDROCHLORIDE TABLETS 25MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover MECLIZINE HYDROCHLORIDE TABLETS 25MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEDROXYPROGESTERONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEDROXYPROGESTERONE 2.5MG ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 2.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEDROXYPROGESTERONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEDROXYPROGESTERONE ACETATE INJECTION SUSPENSION 150MG 1 VIALSD CRTN ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE ACETATE INJECTION SUSPENSION 150MG 1 VIALSD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEFLOQUINE HCL 250MG TABLET 25 BOT ![Compare how all Medicare Part D PDP plans in PA cover MEFLOQUINE HCL 250MG TABLET 25 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEGESTROL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEGESTROL ACETATE 400MG/10ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL ACETATE 400MG/10ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEGESTROL ACETATE 40MG TABLET (250 CT) ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL ACETATE 40MG TABLET (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MELOXICAM 15MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover MELOXICAM 15MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MELOXICAM 7.5MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in PA cover MELOXICAM 7.5MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MELOXICAM TABLETS 7.5MG ![Compare how all Medicare Part D PDP plans in PA cover MELOXICAM TABLETS 7.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MENACTRA INJECTION 4MCG/0.5ML 5 X .5ML SYR ![Compare how all Medicare Part D PDP plans in PA cover MENACTRA INJECTION 4MCG/0.5ML 5 X .5ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MENOMUNE-A/C/Y/W-135 VIAL ![Compare how all Medicare Part D PDP plans in PA cover MENOMUNE-A/C/Y/W-135 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MEPERIDINE 10MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE 10MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPERIDINE 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPERIDINE 50MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE 50MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPERIDINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPERIDINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEPERIDINE HCL INJECTION 75MG 25 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE HCL INJECTION 75MG 25 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPERIDINE HCL TABLET 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE HCL TABLET 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPERIDINE HYDROCHLORIDE INJECTION 100MG/ML 25 X 1 ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover MEPERIDINE HYDROCHLORIDE INJECTION 100MG/ML 25 X 1 ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPROBAMATE 200MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEPROBAMATE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPROBAMATE 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MEPROBAMATE 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEPRON 750MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in PA cover MEPRON 750MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MERCAPTOPURINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MERCAPTOPURINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MERREM INJECTION 500MG 10X20MLVIALS VIAL ![Compare how all Medicare Part D PDP plans in PA cover MERREM INJECTION 500MG 10X20MLVIALS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
MERUVAX II VACCINE/DILUENT ![Compare how all Medicare Part D PDP plans in PA cover MERUVAX II VACCINE/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MESNEX 400MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MESNEX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
METADATE CD 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METADATE CD 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METADATE CD 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METADATE CD 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
METADATE CD 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METADATE CD 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
METADATE CD 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METADATE CD 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
METADATE CD 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METADATE CD 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
METADATE CD 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METADATE CD 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
METFORMIN HCL 1000MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 1000MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METFORMIN HCL 500MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 500MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METFORMIN HCL 850MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHADONE 10MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover METHADONE 10MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHADONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover METHADONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHADONE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHADONE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHAZOLAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHAZOLAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHAZOLAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHAZOLAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHIMAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in PA cover METHIMAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHIMAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in PA cover METHIMAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHOCARBAMOL 750MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHOCARBAMOL 750MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHOTREXATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHOTREXATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHOTREXATE INJECTION 25 MG/ML ![Compare how all Medicare Part D PDP plans in PA cover METHOTREXATE INJECTION 25 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHSCOPOLAMINE BROMIDE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHSCOPOLAMINE BROMIDE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLDOPA 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLDOPA 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLDOPA 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLDOPA 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLDOPA/HCTZ 250-15 TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLDOPA/HCTZ 250-15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLDOPA/HCTZ 250-25 TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLDOPA/HCTZ 250-25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN 10 MG CHEWABLE ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN 10 MG CHEWABLE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN 2.5 MG CHEWABLE TAB ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN 2.5 MG CHEWABLE TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN 5 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN 5 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN ER 10MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN ER 10MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN ER 20MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN ER 20MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN SOLUTION 5MG/5ML 500 ML BOT ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN SOLUTION 5MG/5ML 500 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLIN TABLET 5MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHYLIN TABLET 5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPHENIDATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPHENIDATE 2 MG/ML ORAL SOLUTION [METHYLIN] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 2 MG/ML ORAL SOLUTION [METHYLIN].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPHENIDATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPHENIDATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPHENIDATE TABLETS 20MG 100 TABS BOT ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE TABLETS 20MG 100 TABS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPR ACE INJ 80MG/ML ![Compare how all Medicare Part D PDP plans in PA cover METHYLPR ACE INJ 80MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPREDNISOLONE 1GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPREDNISOLONE 4 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 4 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPREDNISOLONE 40MG/ML VL 5ML ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 40MG/ML VL 5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 125MG 25X125MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 125MG 25X125MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 40MG 25X40MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 40MG 25X40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METIPRANOLOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover METIPRANOLOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOCLOPRAMIDE HYDROCHLORIDE TABLETS 10MG 500 BOTPL ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE HYDROCHLORIDE TABLETS 10MG 500 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOCLOPRAMIDE INJECTION ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOCLOPRAMIDE SOLUTION ORAL USP 5MG 1 PT BOT ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE SOLUTION ORAL USP 5MG 1 PT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOCLOPRAMIDE TABLETS ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOLAZONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOLAZONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOLAZONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL SUCCINATE 25MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCCINATE 25MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL SUCCINATE 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCCINATE 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL SUCCINATE TABLETS EXTENDED RELEASE 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCCINATE TABLETS EXTENDED RELEASE 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL SUCINNATE TABLETS EXTENDED RELEASE 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCINNATE TABLETS EXTENDED RELEASE 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL TARTRATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL TARTRATE INJECTION USP 5MG 10X5ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE INJECTION USP 5MG 10X5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL TARTRATE TABLET USP 100MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE TABLET USP 100MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METROGEL TOPICAL 1% GEL ![Compare how all Medicare Part D PDP plans in PA cover METROGEL TOPICAL 1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
METRONIDAZOLE 0.75% CREAM ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 0.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METRONIDAZOLE 0.75% LOTION ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 0.75% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METRONIDAZOLE 375MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 375MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METRONIDAZOLE TABLETS USP 250MG 250 BOTPL ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TABLETS USP 250MG 250 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METRONIDAZOLE TABLETS USP 500MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TABLETS USP 500MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEXILETINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEXILETINE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MEXILETINE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MICARDIS 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICARDIS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
MICARDIS 40MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICARDIS 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
MICARDIS 80MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICARDIS 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
MICARDIS HCT 40/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICARDIS HCT 40/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
MICARDIS HCT 80/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICARDIS HCT 80/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
MICARDIS HCT 80/25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICARDIS HCT 80/25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MICROGESTIN 1-0.02MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN 1-0.02MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MICROGESTIN 1.5-0.03MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN 1.5-0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MICROGESTIN FE 1.5/30 TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN FE 1.5/30 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MICROGESTIN FE 1/20 TABLET ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN FE 1/20 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOCYCLINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOCYCLINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOCYCLINE HCL 100MG TABLET 60 EA ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE HCL 100MG TABLET 60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOCYCLINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOCYCLINE HCL 75MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE HCL 75MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOCYCLINE HYDROCHLORIDE TABLETS 50MG ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE HYDROCHLORIDE TABLETS 50MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MINOXIDIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MINOXIDIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MINOXIDIL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MINOXIDIL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MIRAPEX 0.125MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRAPEX 0.125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MIRAPEX 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRAPEX 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MIRAPEX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRAPEX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MIRAPEX 0.75MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRAPEX 0.75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MIRAPEX 1.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRAPEX 1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MIRAPEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRAPEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MIRTAZAPINE 15MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 15MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MIRTAZAPINE 15MG TABLET RAPID DISSOLVE ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 15MG TABLET RAPID DISSOLVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MIRTAZAPINE 30MG TABLET RAPID DISSOLVE ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 30MG TABLET RAPID DISSOLVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MIRTAZAPINE ORALLY DISINTEGRATING TABLETS 45MG 10 X 3 BOX ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE ORALLY DISINTEGRATING TABLETS 45MG 10 X 3 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MIRTAZAPINE TABLET 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE TABLET 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MIRTAZAPINE TABLET 7.5MG (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE TABLET 7.5MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MIRTAZAPINE TABLETS 45MG 30 BOT ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE TABLETS 45MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MISOPROSTOL 100MCG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MISOPROSTOL 100MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MISOPROSTOL 200MCG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MISOPROSTOL 200MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MITOXANTRONE INJECTION 2MG 125ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MITOXANTRONE INJECTION 2MG 125ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MOEXIPRIL HCL 15MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL HCL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MOEXIPRIL HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MOMETASONE FUROATE CREAM 0.1% 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE CREAM 0.1% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MOMETASONE FUROATE OINTMENT 0.1% 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE OINTMENT 0.1% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOMETASONE FUROATE TOPICAL SOLUTION 0.1% ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE TOPICAL SOLUTION 0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE 15MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 15MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE INJECTION 0.5MG 5X10ML VIALGL ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE INJECTION 0.5MG 5X10ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE INJECTION 1MG 5X10ML VIALGL ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE INJECTION 1MG 5X10ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE TABLET ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE TABLET ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MORPHINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MULTAQ DRONEDARONE TABLETS 400MG 60 BOT ![Compare how all Medicare Part D PDP plans in PA cover MULTAQ DRONEDARONE TABLETS 400MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MUPIROCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover MUPIROCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MYCOBUTIN 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYCOBUTIN 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
MYCOPHENOLATE MOFETIL CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE MOFETIL CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
MYOZYME 50MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MYOZYME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
MYSOLINE ANTICONVULSANT TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover MYSOLINE ANTICONVULSANT TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |