2011 Medicare Part D Plan Formulary Information |
MedicareRx Rewards Standard (PDP) (S5960-126-0)
Benefit Details
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The MedicareRx Rewards Standard (PDP) (S5960-126-0) Formulary Drugs Starting with the Letter M in CMS PDP Region 20 which includes: MS
|
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 MS cover M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MAGENSIUM SULFATE IN 5% DEXTROSE INJECTION 5-1 24 X 100ML CTR ![Compare how all Medicare Part D PDP plans in MS cover MAGENSIUM SULFATE IN 5% DEXTROSE INJECTION 5-1 24 X 100ML CTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MAGNESIUM SULFATE 4% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover MAGNESIUM SULFATE 4% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MAGNESIUM SULFATE 8% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover MAGNESIUM SULFATE 8% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MAGNESIUM SULFATE INJECTION 5 GM/10ML ![Compare how all Medicare Part D PDP plans in MS cover MAGNESIUM SULFATE INJECTION 5 GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MALATHION 5 MG/ML TOPICAL LOTION ![Compare how all Medicare Part D PDP plans in MS cover MALATHION 5 MG/ML TOPICAL LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MAPROTILINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MAPROTILINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
MAPROTILINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MAPROTILINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
MAPROTILINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MAPROTILINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MARGESIC H 5MG-500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MARGESIC H 5MG-500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:240 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MARPLAN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MATULANE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MATULANE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty Tier Drugs |
25% | N/A | None |
MAXALT 10MG TABLET 12 CRTN ![Compare how all Medicare Part D PDP plans in MS cover MAXALT 10MG TABLET 12 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | Q:12 /30Days |
MAXALT 5MG TABLET 12 CRTN ![Compare how all Medicare Part D PDP plans in MS cover MAXALT 5MG TABLET 12 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | Q:12 /30Days |
MAXALT MLT 10MG TABLET 4X3 UNIT DOSE CASE ![Compare how all Medicare Part D PDP plans in MS cover MAXALT MLT 10MG TABLET 4X3 UNIT DOSE CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | Q:12 /30Days |
MAXALT MLT 5MG TABLET 4X3 UNIT CASE ![Compare how all Medicare Part D PDP plans in MS cover MAXALT MLT 5MG TABLET 4X3 UNIT CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | Q:12 /30Days |
MAXIPIME 2G ADD-VANTAGE VL ![Compare how all Medicare Part D PDP plans in MS cover MAXIPIME 2G ADD-VANTAGE VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEBENDAZOLE 100MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in MS cover MEBENDAZOLE 100MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MECLIZINE HYDROCHLORIDE TABLETS 12.5MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover MECLIZINE HYDROCHLORIDE TABLETS 12.5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MECLIZINE HYDROCHLORIDE TABLETS 25MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover MECLIZINE HYDROCHLORIDE TABLETS 25MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MECLOFENAMATE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MECLOFENAMATE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MECLOFENAMATE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MECLOFENAMATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEDROXYPROGESTERONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MEDROXYPROGESTERONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
MEDROXYPROGESTERONE 2.5MG ![Compare how all Medicare Part D PDP plans in MS cover MEDROXYPROGESTERONE 2.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
MEDROXYPROGESTERONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MEDROXYPROGESTERONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
MEDROXYPROGESTERONE ACETATE INJECTION SUSPENSION 150MG 1 VIALSD CRTN ![Compare how all Medicare Part D PDP plans in MS cover MEDROXYPROGESTERONE ACETATE INJECTION SUSPENSION 150MG 1 VIALSD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEFLOQUINE HCL 250MG TABLET 25 BOT ![Compare how all Medicare Part D PDP plans in MS cover MEFLOQUINE HCL 250MG TABLET 25 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEGESTROL 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MEGESTROL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEGESTROL ACETATE 400MG/10ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in MS cover MEGESTROL ACETATE 400MG/10ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEGESTROL ACETATE 40MG TABLET (250 CT) ![Compare how all Medicare Part D PDP plans in MS cover MEGESTROL ACETATE 40MG TABLET (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MELOXICAM 15MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover MELOXICAM 15MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | Q:30 /30Days |
MELOXICAM 7.5MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in MS cover MELOXICAM 7.5MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MELOXICAM TABLETS 7.5MG ![Compare how all Medicare Part D PDP plans in MS cover MELOXICAM TABLETS 7.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | Q:60 /30Days |
MELPHALAN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover MELPHALAN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | P |
MENACTRA INJECTION 4MCG/0.5ML 5 X .5ML SYR ![Compare how all Medicare Part D PDP plans in MS cover MENACTRA INJECTION 4MCG/0.5ML 5 X .5ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MENOMUNE-A/C/Y/W-135 VIAL ![Compare how all Medicare Part D PDP plans in MS cover MENOMUNE-A/C/Y/W-135 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MENVEO INJECTION KIT ![Compare how all Medicare Part D PDP plans in MS cover MENVEO INJECTION KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MEPERIDINE 10MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE 10MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEPERIDINE 25MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE 25MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEPERIDINE 50MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE 50MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEPERIDINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEPERIDINE HCL INJECTION 75MG 25 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE HCL INJECTION 75MG 25 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEPERIDINE HCL TABLET 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE HCL TABLET 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEPERIDINE HYDROCHLORIDE INJECTION 100MG/ML 25 X 1 ML VIALSD ![Compare how all Medicare Part D PDP plans in MS cover MEPERIDINE HYDROCHLORIDE INJECTION 100MG/ML 25 X 1 ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MEPROBAMATE 200MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MEPROBAMATE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:120 /30Days |
MEPROBAMATE 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MEPROBAMATE 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:180 /30Days |
MEPRON 750MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MS cover MEPRON 750MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty Tier Drugs |
25% | N/A | None |
MERCAPTOPURINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MERCAPTOPURINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEROPENEM FOR INJECTION ![Compare how all Medicare Part D PDP plans in MS cover MEROPENEM FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MERREM INJECTION 500MG 10X20MLVIALS VIAL ![Compare how all Medicare Part D PDP plans in MS cover MERREM INJECTION 500MG 10X20MLVIALS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MERUVAX II VACCINE/DILUENT ![Compare how all Medicare Part D PDP plans in MS cover MERUVAX II VACCINE/DILUENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MESALAMINE 4G/60ML ENEMA ![Compare how all Medicare Part D PDP plans in MS cover MESALAMINE 4G/60ML ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MESNA INJECTION 1GM/ML 10ML VIALMD CRTN ![Compare how all Medicare Part D PDP plans in MS cover MESNA INJECTION 1GM/ML 10ML VIALMD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | P |
MESNEX 400MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MESNEX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MESNEX INJECTION ![Compare how all Medicare Part D PDP plans in MS cover MESNEX INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | P |
MESTINON 180MG TIMESPAN ![Compare how all Medicare Part D PDP plans in MS cover MESTINON 180MG TIMESPAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MESTINON 60MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in MS cover MESTINON 60MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
METAPROTERENOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METAPROTERENOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METAPROTERENOL 10MG/5ML SYR ![Compare how all Medicare Part D PDP plans in MS cover METAPROTERENOL 10MG/5ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METAPROTERENOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METAPROTERENOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METAXALONE 800 MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METAXALONE 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METFORMIN HCL 1000MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover METFORMIN HCL 1000MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METFORMIN HCL 500MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover METFORMIN HCL 500MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METFORMIN HCL 850MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METFORMIN HCL 850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METFORMIN HCL ER 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in MS cover METFORMIN HCL ER 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METFORMIN HCL ER 750MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover METFORMIN HCL ER 750MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADONE 10MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover METHADONE 10MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover METHADONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADONE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover METHADONE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADONE HCL ORAL CONCENTRATE 10MG 946ML BOT ![Compare how all Medicare Part D PDP plans in MS cover METHADONE HCL ORAL CONCENTRATE 10MG 946ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADONE HYDROCHLORIDE INJECTION 10MG/ML ![Compare how all Medicare Part D PDP plans in MS cover METHADONE HYDROCHLORIDE INJECTION 10MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHADONE HYDROCHLORIDE TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in MS cover METHADONE HYDROCHLORIDE TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADOSE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHADOSE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHADOSE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHADOSE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHAZOLAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHAZOLAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHAZOLAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHAZOLAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHENAMINE HIPPURATE 1G TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHENAMINE HIPPURATE 1G TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHIMAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in MS cover METHIMAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHIMAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in MS cover METHIMAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHOCARBAMOL 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHOCARBAMOL 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHOCARBAMOL 750MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MS cover METHOCARBAMOL 750MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHOTREXATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHOTREXATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHOTREXATE FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in MS cover METHOTREXATE FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHOTREXATE INJECTION 25 MG/ML ![Compare how all Medicare Part D PDP plans in MS cover METHOTREXATE INJECTION 25 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHSCOPOLAMINE BROMIDE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHSCOPOLAMINE BROMIDE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHSCOPOLAMINE BROMIDE TABLETS 5MG 60 BOT ![Compare how all Medicare Part D PDP plans in MS cover METHSCOPOLAMINE BROMIDE TABLETS 5MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHYLDOPA 250MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLDOPA 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLDOPA 500MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLDOPA 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHYLDOPA/HCTZ 250-15 TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLDOPA/HCTZ 250-15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHYLDOPA/HCTZ 250-25 TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLDOPA/HCTZ 250-25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METHYLDOPATE 250MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover METHYLDOPATE 250MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHYLIN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover METHYLIN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLIN 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLIN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLIN ER 10MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover METHYLIN ER 10MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLIN ER 20MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover METHYLIN ER 20MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLIN TABLET 5MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover METHYLIN TABLET 5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLPHENIDATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLPHENIDATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLPHENIDATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLPHENIDATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPHENIDATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover METHYLPHENIDATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLPHENIDATE TABLETS 20MG 100 TABS BOT ![Compare how all Medicare Part D PDP plans in MS cover METHYLPHENIDATE TABLETS 20MG 100 TABS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:90 /30Days |
METHYLPR ACE INJ 80MG/ML ![Compare how all Medicare Part D PDP plans in MS cover METHYLPR ACE INJ 80MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHYLPREDNISOLONE 16MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METHYLPREDNISOLONE 1GM VIAL ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHYLPREDNISOLONE 32MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METHYLPREDNISOLONE 4 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE 4 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METHYLPREDNISOLONE 40MG/ML VL 5ML ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE 40MG/ML VL 5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHYLPREDNISOLONE 8 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE 8 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 125MG 25X125MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 125MG 25X125MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 40MG 25X40MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 40MG 25X40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPREDNISOLONE TABLET 4MG 21 PKGCOM ![Compare how all Medicare Part D PDP plans in MS cover METHYLPREDNISOLONE TABLET 4MG 21 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METIPRANOLOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in MS cover METIPRANOLOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METOCLOPRAMIDE HYDROCHLORIDE TABLETS 10MG 500 BOTPL ![Compare how all Medicare Part D PDP plans in MS cover METOCLOPRAMIDE HYDROCHLORIDE TABLETS 10MG 500 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METOCLOPRAMIDE INJECTION ![Compare how all Medicare Part D PDP plans in MS cover METOCLOPRAMIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METOCLOPRAMIDE SOLUTION ORAL USP 5MG 1 PT BOT ![Compare how all Medicare Part D PDP plans in MS cover METOCLOPRAMIDE SOLUTION ORAL USP 5MG 1 PT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METOCLOPRAMIDE TABLETS ![Compare how all Medicare Part D PDP plans in MS cover METOCLOPRAMIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METOPROLOL TARTRATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL TARTRATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METOPROLOL TARTRATE INJECTION USP 5MG 10X5ML VIALSD ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL TARTRATE INJECTION USP 5MG 10X5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METOPROLOL TARTRATE TABLET USP 100MG (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL TARTRATE TABLET USP 100MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE 0.75% CREAM ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE 0.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE 0.75% LOTION ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE 0.75% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE 375MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE 375MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE INJECTION ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
METRONIDAZOLE TABLETS USP 250MG 250 BOTPL ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE TABLETS USP 250MG 250 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE TABLETS USP 500MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE TABLETS USP 500MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
METRONIDAZOLE VAGINAL GEL ![Compare how all Medicare Part D PDP plans in MS cover METRONIDAZOLE VAGINAL GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEXILETINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MEXILETINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEXILETINE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MEXILETINE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MEXILETINE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MEXILETINE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MIACALCIN 200IU/ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover MIACALCIN 200IU/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | P |
MICARDIS 20MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICARDIS 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MICARDIS 40MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICARDIS 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MICARDIS 80MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICARDIS 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MICARDIS HCT 40/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICARDIS HCT 40/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MICARDIS HCT 80/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICARDIS HCT 80/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MICARDIS HCT 80/25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICARDIS HCT 80/25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MICONAZOLE 3 200MG SUPPOS. ![Compare how all Medicare Part D PDP plans in MS cover MICONAZOLE 3 200MG SUPPOS..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:6 /30Days |
MICROGESTIN 1-0.02MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICROGESTIN 1-0.02MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:21 /21Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MICROGESTIN 1.5-0.03MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICROGESTIN 1.5-0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:21 /21Days |
MICROGESTIN FE 1.5/30 TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICROGESTIN FE 1.5/30 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:28 /28Days |
MICROGESTIN FE 1/20 TABLET ![Compare how all Medicare Part D PDP plans in MS cover MICROGESTIN FE 1/20 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:28 /28Days |
MIDODRINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MIDODRINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MIDODRINE HCL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MIDODRINE HCL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MIDODRINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MIDODRINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE HCL 100MG TABLET 60 EA ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HCL 100MG TABLET 60 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE HCL 75MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HCL 75MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MINOCYCLINE HYDROCHLORIDE TABLETS 50MG ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HYDROCHLORIDE TABLETS 50MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 45MG ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 135MG ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 90MG ![Compare how all Medicare Part D PDP plans in MS cover MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 90MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOXIDIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MINOXIDIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MINOXIDIL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MINOXIDIL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MIRAPEX 0.75MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MIRAPEX 0.75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MIRTAZAPINE 15MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MS cover MIRTAZAPINE 15MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
MIRTAZAPINE 15MG TABLET RAPID DISSOLVE ![Compare how all Medicare Part D PDP plans in MS cover MIRTAZAPINE 15MG TABLET RAPID DISSOLVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
MIRTAZAPINE 30MG TABLET RAPID DISSOLVE ![Compare how all Medicare Part D PDP plans in MS cover MIRTAZAPINE 30MG TABLET RAPID DISSOLVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
MIRTAZAPINE ORALLY DISINTEGRATING TABLETS 45MG 10 X 3 BOX ![Compare how all Medicare Part D PDP plans in MS cover MIRTAZAPINE ORALLY DISINTEGRATING TABLETS 45MG 10 X 3 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
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 MS cover MIRTAZAPINE TABLET 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
MIRTAZAPINE TABLET 7.5MG (30 CT) ![Compare how all Medicare Part D PDP plans in MS cover MIRTAZAPINE TABLET 7.5MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
MIRTAZAPINE TABLETS 45MG 30 BOT ![Compare how all Medicare Part D PDP plans in MS cover MIRTAZAPINE TABLETS 45MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:30 /30Days |
MISOPROSTOL 100MCG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MISOPROSTOL 100MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MISOPROSTOL 200MCG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MISOPROSTOL 200MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MITOMYCIN POWDER FOR INJECTION USP 20MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover MITOMYCIN POWDER FOR INJECTION USP 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | P |
MITOXANTRONE INJECTION 2MG 125ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover MITOXANTRONE INJECTION 2MG 125ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | P |
MOEXIPRIL HCL 15MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MOEXIPRIL HCL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MOEXIPRIL HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MOEXIPRIL HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in MS cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MOMETASONE FUROATE CREAM 0.1% 45GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover MOMETASONE FUROATE CREAM 0.1% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MOMETASONE FUROATE OINTMENT 0.1% 45GM TUBE ![Compare how all Medicare Part D PDP plans in MS cover MOMETASONE FUROATE OINTMENT 0.1% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MOMETASONE FUROATE TOPICAL SOLUTION 0.1% ![Compare how all Medicare Part D PDP plans in MS cover MOMETASONE FUROATE TOPICAL SOLUTION 0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN ![Compare how all Medicare Part D PDP plans in MS cover MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:28 /28Days |
MORPHINE SULFATE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:180 /30Days |
MORPHINE SULFATE 15MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE 15MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:120 /30Days |
MORPHINE SULFATE 20 MG/ML SOL ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE 20 MG/ML SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MORPHINE SULFATE 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:180 /30Days |
MORPHINE SULFATE 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:120 /30Days |
MORPHINE SULFATE 5MG 25 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE 5MG 25 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE INJECTION 0.5MG 5X10ML VIALGL ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE INJECTION 0.5MG 5X10ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MORPHINE SULFATE INJECTION 1MG 5X10ML VIALGL ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE INJECTION 1MG 5X10ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MORPHINE SULFATE ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MORPHINE SULFATE ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MORPHINE SULFATE TABLET ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE TABLET ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | Q:120 /30Days |
MORPHINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MORPHINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in MS cover MORPHINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MUPIROCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in MS cover MUPIROCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | None |
MUSTARGEN 10MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover MUSTARGEN 10MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 Injectable Drugs |
25% | 25% | None |
MYCAMINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in MS cover MYCAMINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty Tier Drugs |
25% | N/A | None |
MYCAMINE FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in MS cover MYCAMINE FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty Tier Drugs |
25% | N/A | 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 MS cover MYCOBUTIN 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 Preferred Brand Drugs |
$33.00 | $82.50 | None |
MYCOPHENOLATE MOFETIL CAPSULES 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in MS cover MYCOPHENOLATE MOFETIL CAPSULES 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | P |
MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT ![Compare how all Medicare Part D PDP plans in MS cover MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 Non-Preferred Generic Drugs |
$7.00 | $10.50 | P |
MYDRAL 0.5% DROPS ![Compare how all Medicare Part D PDP plans in MS cover MYDRAL 0.5% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |
MYDRAL 1% DROPS ![Compare how all Medicare Part D PDP plans in MS cover MYDRAL 1% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic Drugs |
$4.00 | $6.00 | None |