2012 Medicare Part D Plan Formulary Information |
Gundersen Lutheran Senior Pref. Value (w/RX) (HMO) (H5262-003-0)
Benefit Details
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The Gundersen Lutheran Senior Pref. Value (w/RX) (HMO) (H5262-003-0) Formulary Drugs Starting with the Letter M in Juneau County, WI: CMS MA Region 14 which includes: WI
|
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 WI 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 |
$44.00 | N/A | None |
MAGNESIUM SULFATE 4% IV SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MAGNESIUM SULFATE 4% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MAGNESIUM SULFATE 8% IV SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MAGNESIUM SULFATE 8% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MAGNESIUM SULFATE INJECTION 5 GM/10ML ![Compare how all Medicare Part D PDP plans in WI cover MAGNESIUM SULFATE INJECTION 5 GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MALARONE 250-100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MALARONE 250-100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MALARONE 62.5-25MG PED TABLET ![Compare how all Medicare Part D PDP plans in WI cover MALARONE 62.5-25MG PED TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
Malathion 5mg/mL 1 BOTTLE in 1 CARTON / 59 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Malathion 5mg/mL 1 BOTTLE in 1 CARTON / 59 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MAPROTILINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAPROTILINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MAPROTILINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAPROTILINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MAPROTILINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAPROTILINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MARGESIC H 5MG-500MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MARGESIC H 5MG-500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:240 /30Days |
MARPLAN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MATULANE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MATULANE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MAXALT 10MG TABLET 12 CRTN ![Compare how all Medicare Part D PDP plans in WI cover MAXALT 10MG TABLET 12 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:18 /30Days |
MAXALT 5MG TABLET 12 CRTN ![Compare how all Medicare Part D PDP plans in WI cover MAXALT 5MG TABLET 12 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:18 /30Days |
MAXALT MLT 10MG TABLET 4X3 UNIT DOSE CASE ![Compare how all Medicare Part D PDP plans in WI cover MAXALT MLT 10MG TABLET 4X3 UNIT DOSE CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:18 /30Days |
MAXALT MLT 5MG TABLET 4X3 UNIT CASE ![Compare how all Medicare Part D PDP plans in WI cover MAXALT MLT 5MG TABLET 4X3 UNIT CASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:18 /30Days |
MAXIDEX OPHTHALMIC SUSPENSION 0.1% 5ML BOT ![Compare how all Medicare Part D PDP plans in WI cover MAXIDEX OPHTHALMIC SUSPENSION 0.1% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MEBENDAZOLE 100MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in WI cover MEBENDAZOLE 100MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MECLIZINE HYDROCHLORIDE TABLETS 12.5MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover MECLIZINE HYDROCHLORIDE TABLETS 12.5MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MECLIZINE HYDROCHLORIDE TABLETS 25MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover MECLIZINE HYDROCHLORIDE TABLETS 25MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MECLOFENAMATE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MECLOFENAMATE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MECLOFENAMATE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MECLOFENAMATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MEDROXYPROGESTERONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEDROXYPROGESTERONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MEDROXYPROGESTERONE 2.5MG ![Compare how all Medicare Part D PDP plans in WI cover MEDROXYPROGESTERONE 2.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MEDROXYPROGESTERONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEDROXYPROGESTERONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MEDROXYPROGESTERONE ACETATE INJECTION SUSPENSION 150MG 1 VIALSD CRTN ![Compare how all Medicare Part D PDP plans in WI cover MEDROXYPROGESTERONE ACETATE INJECTION SUSPENSION 150MG 1 VIALSD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:1 /90Days |
MEFENAMIC ACID CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover MEFENAMIC ACID CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | S |
MEFLOQUINE HCL 250MG TABLET 25 BOT ![Compare how all Medicare Part D PDP plans in WI cover MEFLOQUINE HCL 250MG TABLET 25 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MEGACE ES 625MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover MEGACE ES 625MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MEGESTROL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEGESTROL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MEGESTROL ACETATE 400MG/10ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in WI cover MEGESTROL ACETATE 400MG/10ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | 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 WI cover MEGESTROL ACETATE 40MG TABLET (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Meloxicam 15mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Meloxicam 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
Meloxicam 7.5mg 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Meloxicam 7.5mg 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
MELOXICAM 7.5MG/5ML SUSPENSION ORAL ![Compare how all Medicare Part D PDP plans in WI cover MELOXICAM 7.5MG/5ML SUSPENSION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:300 /30Days |
MENACTRA INJECTION 4MCG/0.5ML 5 X .5ML SYR ![Compare how all Medicare Part D PDP plans in WI cover MENACTRA INJECTION 4MCG/0.5ML 5 X .5ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | None |
MENEST 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MENEST 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MENEST 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MENEST 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MENEST 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MENEST 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MENEST 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MENEST 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MENOMUNE-A/C/Y/W-135 VIAL ![Compare how all Medicare Part D PDP plans in WI cover MENOMUNE-A/C/Y/W-135 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | None |
MENVEO INJECTION KIT ![Compare how all Medicare Part D PDP plans in WI cover MENVEO INJECTION KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Meprobamate 200mg/1 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Meprobamate 200mg/1 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Meprobamate 400mg/1 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Meprobamate 400mg/1 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MEPRON 750MG/5ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in WI cover MEPRON 750MG/5ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | P |
MERCAPTOPURINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MERCAPTOPURINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MERREM INJECTION 500MG 10X20MLVIALS VIAL ![Compare how all Medicare Part D PDP plans in WI cover MERREM INJECTION 500MG 10X20MLVIALS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
Mesalamine 4g/60mL 7 BOTTLE, UNIT-DOSE in 1 CARTON / 60 mL in 1 BOTTLE, UNIT-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Mesalamine 4g/60mL 7 BOTTLE, UNIT-DOSE in 1 CARTON / 60 mL in 1 BOTTLE, UNIT-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MESNA INJECTION 1GM/ML 10ML VIALMD CRTN ![Compare how all Medicare Part D PDP plans in WI cover MESNA INJECTION 1GM/ML 10ML VIALMD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MESNEX 400MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MESNEX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MESTINON 180MG TIMESPAN ![Compare how all Medicare Part D PDP plans in WI cover MESTINON 180MG TIMESPAN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | None |
MESTINON 60MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in WI cover MESTINON 60MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | None |
METADATE ER 20MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover METADATE ER 20MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METAPROTERENOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METAPROTERENOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METAPROTERENOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METAPROTERENOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Metaproterenol Sulfate 10mg/5mL 473 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Metaproterenol Sulfate 10mg/5mL 473 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METAXALONE 800 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METAXALONE 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METFORMIN HCL 1000MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover METFORMIN HCL 1000MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:90 /30Days |
METFORMIN HCL 500MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover METFORMIN HCL 500MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:150 /30Days |
METFORMIN HCL 850MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METFORMIN HCL 850MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:90 /30Days |
METFORMIN HCL ER 500MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in WI cover METFORMIN HCL ER 500MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:120 /30Days |
METFORMIN HYDROCHLORIDE 750mg/1 ![Compare how all Medicare Part D PDP plans in WI cover METFORMIN HYDROCHLORIDE 750mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:90 /30Days |
METHADONE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover METHADONE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHADONE HYDROCHLORIDE 10mg/1 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover METHADONE HYDROCHLORIDE 10mg/1 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Methadone Hydrochloride 10mg/mL ![Compare how all Medicare Part D PDP plans in WI cover Methadone Hydrochloride 10mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHADONE HYDROCHLORIDE INJECTION 10MG/ML ![Compare how all Medicare Part D PDP plans in WI cover METHADONE HYDROCHLORIDE INJECTION 10MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHADOSE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHADOSE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHADOSE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHADOSE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHAZOLAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHAZOLAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHAZOLAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHAZOLAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Methenamine Hippurate 1g/1 ![Compare how all Medicare Part D PDP plans in WI cover Methenamine Hippurate 1g/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METHERGINE 0.2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHERGINE 0.2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
Methimazole 10mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Methimazole 10mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHIMAZOLE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover METHIMAZOLE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Methocarbamol 500mg/1 100 TABLET in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Methocarbamol 500mg/1 100 TABLET in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHOCARBAMOL 750MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover METHOCARBAMOL 750MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHOTREXATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHOTREXATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHOTREXATE FOR INJECTION 1 GM/ML ![Compare how all Medicare Part D PDP plans in WI cover METHOTREXATE FOR INJECTION 1 GM/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHOTREXATE INJECTION 25 MG/ML ![Compare how all Medicare Part D PDP plans in WI cover METHOTREXATE INJECTION 25 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHSCOPOLAMINE BROMIDE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHSCOPOLAMINE BROMIDE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METHSCOPOLAMINE BROMIDE TABLETS 5MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover METHSCOPOLAMINE BROMIDE TABLETS 5MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METHYCLOTHIAZIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYCLOTHIAZIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHYLDOPA 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLDOPA 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHYLDOPA 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLDOPA 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHYLDOPA/HCTZ 250-15 TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLDOPA/HCTZ 250-15 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHYLDOPA/HCTZ 250-25 TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLDOPA/HCTZ 250-25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLDOPATE 250MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover METHYLDOPATE 250MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
Methylergonovine Maleate 0.2mg/1 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methylergonovine Maleate 0.2mg/1 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
METHYLIN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLIN 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLIN ER 10MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN ER 10MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLIN ER 20MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN ER 20MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLIN TABLET 5MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN TABLET 5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLPHENIDATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLPHENIDATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLPHENIDATE 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
METHYLPHENIDATE TABLETS 20MG 100 TABS BOT ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE TABLETS 20MG 100 TABS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPREDNISOLONE 16MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHYLPREDNISOLONE 1GM VIAL ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHYLPREDNISOLONE 32MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Methylprednisolone 40mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Methylprednisolone 40mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
Methylprednisolone 4mg/1 100 TABLET in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methylprednisolone 4mg/1 100 TABLET in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METHYLPREDNISOLONE 8 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE 8 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Methylprednisolone acetate 80mg/mL 25 VIAL, GLASS in 1 CARTON / 1 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in WI cover Methylprednisolone acetate 80mg/mL 25 VIAL, GLASS in 1 CARTON / 1 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 125MG 25X125MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 125MG 25X125MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 40MG 25X40MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE SODIUM SUCCINATE POWDER FOR INJECTION 40MG 25X40MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METHYLPREDNISOLONE TABLET 4MG 21 PKGCOM ![Compare how all Medicare Part D PDP plans in WI cover METHYLPREDNISOLONE TABLET 4MG 21 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METIPRANOLOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover METIPRANOLOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOCLOPRAMIDE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOCLOPRAMIDE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Metoclopramide 5mg/mL 25 VIAL in 1 TRAY / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover Metoclopramide 5mg/mL 25 VIAL in 1 TRAY / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METOCLOPRAMIDE HYDROCHLORIDE TABLETS 10MG 500 BOTPL ![Compare how all Medicare Part D PDP plans in WI cover METOCLOPRAMIDE HYDROCHLORIDE TABLETS 10MG 500 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOCLOPRAMIDE SOLUTION ORAL USP 5MG 1 PT BOT ![Compare how all Medicare Part D PDP plans in WI cover METOCLOPRAMIDE SOLUTION ORAL USP 5MG 1 PT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOLAZONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOLAZONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOLAZONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOLAZONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOLAZONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOLAZONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOPROLOL SUCCINATE 25MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCCINATE 25MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
METOPROLOL SUCCINATE 50MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCCINATE 50MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:45 /30Days |
METOPROLOL SUCCINATE TABLETS EXTENDED RELEASE 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCCINATE TABLETS EXTENDED RELEASE 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:45 /30Days |
METOPROLOL SUCINNATE TABLETS EXTENDED RELEASE 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCINNATE TABLETS EXTENDED RELEASE 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:60 /30Days |
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 WI cover METOPROLOL TARTRATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOPROLOL TARTRATE INJECTION USP 5MG 10X5ML VIALSD ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL TARTRATE INJECTION USP 5MG 10X5ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOPROLOL TARTRATE TABLET USP 100MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL TARTRATE TABLET USP 100MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METROGEL TOPICAL 1% GEL ![Compare how all Medicare Part D PDP plans in WI cover METROGEL TOPICAL 1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
METRONIDAZOLE 0.75% CREAM ![Compare how all Medicare Part D PDP plans in WI cover METRONIDAZOLE 0.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METRONIDAZOLE 0.75% LOTION ![Compare how all Medicare Part D PDP plans in WI cover METRONIDAZOLE 0.75% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Metronidazole 375mg/1 50 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Metronidazole 375mg/1 50 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METRONIDAZOLE TABLETS USP 250MG 250 BOTPL ![Compare how all Medicare Part D PDP plans in WI cover METRONIDAZOLE TABLETS USP 250MG 250 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METRONIDAZOLE TABLETS USP 500MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WI cover METRONIDAZOLE TABLETS USP 500MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
METRONIDAZOLE VAGINAL GEL ![Compare how all Medicare Part D PDP plans in WI cover METRONIDAZOLE VAGINAL GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MEXILETINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MEXILETINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MEXILETINE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MEXILETINE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MEXILETINE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MEXILETINE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MIACALCIN 200UNITS NASAL SPRA ![Compare how all Medicare Part D PDP plans in WI cover MIACALCIN 200UNITS NASAL SPRA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
Micardis 20mg/1 3 BLISTER PACK in 1 CARTON / 10 TABLET in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Micardis 20mg/1 3 BLISTER PACK in 1 CARTON / 10 TABLET in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | S Q:30 /30Days |
MICARDIS 40MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICARDIS 40MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | S Q:30 /30Days |
MICARDIS 80MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICARDIS 80MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MICARDIS HCT 40/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICARDIS HCT 40/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | S Q:30 /30Days |
MICARDIS HCT 80/12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICARDIS HCT 80/12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | S Q:30 /30Days |
MICARDIS HCT 80/25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICARDIS HCT 80/25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | S Q:30 /30Days |
MICONAZOLE 3 200MG SUPPOS. ![Compare how all Medicare Part D PDP plans in WI cover MICONAZOLE 3 200MG SUPPOS..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:3 /3Days |
MICROGESTIN 1-0.02MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICROGESTIN 1-0.02MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MICROGESTIN 1.5-0.03MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICROGESTIN 1.5-0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MICROGESTIN FE 1.5/30 TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICROGESTIN FE 1.5/30 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MICROGESTIN FE 1/20 TABLET ![Compare how all Medicare Part D PDP plans in WI cover MICROGESTIN FE 1/20 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MIDODRINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIDODRINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MIDODRINE HCL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIDODRINE HCL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MIDODRINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover MIDODRINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MIGERGOT 2-100MG SUPPOSITORY RECTAL ![Compare how all Medicare Part D PDP plans in WI cover MIGERGOT 2-100MG SUPPOSITORY RECTAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MIGRANAL 0.5MG/SPRY AEROSOL SPRAY W/PUMP ![Compare how all Medicare Part D PDP plans in WI cover MIGRANAL 0.5MG/SPRY AEROSOL SPRAY W/PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:16 /30Days |
MINOCYCLINE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MINOCYCLINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MINOCYCLINE HCL 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE HCL 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Minocycline Hydrochloride 100mg/1 60 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Minocycline Hydrochloride 100mg/1 60 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Minocycline Hydrochloride 75mg/1 100 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Minocycline Hydrochloride 75mg/1 100 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MINOCYCLINE HYDROCHLORIDE TABLETS 50MG ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE HYDROCHLORIDE TABLETS 50MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 135MG ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 45MG ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 90MG ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE HYDROCHLORIDE TABLETS EXTENDED RELEASE 90MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MINOXIDIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MINOXIDIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MINOXIDIL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MINOXIDIL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MIRAPEX 0.125MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRAPEX 0.125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MIRAPEX 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRAPEX 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MIRAPEX 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRAPEX 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MIRAPEX 0.75MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRAPEX 0.75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MIRAPEX 1.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRAPEX 1.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MIRAPEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRAPEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MIRTAZAPINE 15MG TABLET RAPID DISSOLVE ![Compare how all Medicare Part D PDP plans in WI cover MIRTAZAPINE 15MG TABLET RAPID DISSOLVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:30 /30Days |
Mirtazapine 15mg/1 1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Mirtazapine 15mg/1 1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
MIRTAZAPINE 30MG TABLET RAPID DISSOLVE ![Compare how all Medicare Part D PDP plans in WI cover MIRTAZAPINE 30MG TABLET RAPID DISSOLVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
mirtazapine 45mg/1 1000 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover mirtazapine 45mg/1 1000 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
Mirtazapine 7.5mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Mirtazapine 7.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
MIRTAZAPINE ORALLY DISINTEGRATING TABLETS 45MG 10 X 3 BOX ![Compare how all Medicare Part D PDP plans in WI cover MIRTAZAPINE ORALLY DISINTEGRATING TABLETS 45MG 10 X 3 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | Q:30 /30Days |
MIRTAZAPINE TABLET 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover MIRTAZAPINE TABLET 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:30 /30Days |
MISOPROSTOL 100MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MISOPROSTOL 100MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MISOPROSTOL 200MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MISOPROSTOL 200MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MITOXANTRONE INJECTION 2MG 125ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover MITOXANTRONE INJECTION 2MG 125ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$44.00 | N/A | P |
MOEXIPRIL HCL 15MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MOEXIPRIL HCL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MOEXIPRIL HCL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MOEXIPRIL HCL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | 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 WI cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
Mometasone Furoate 1mg/g ![Compare how all Medicare Part D PDP plans in WI cover Mometasone Furoate 1mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MOMETASONE FUROATE OINTMENT 0.1% 45GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover MOMETASONE FUROATE OINTMENT 0.1% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MOMETASONE FUROATE TOPICAL SOLUTION 0.1% ![Compare how all Medicare Part D PDP plans in WI cover MOMETASONE FUROATE TOPICAL SOLUTION 0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN ![Compare how all Medicare Part D PDP plans in WI cover MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | None |
MONUROL PAK GRANULES 3 GM ![Compare how all Medicare Part D PDP plans in WI cover MONUROL PAK GRANULES 3 GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
MORPHINE SULFATE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:180 /30Days |
Morphine Sulfate 100mg/5mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Morphine Sulfate 100mg/5mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MORPHINE SULFATE 15MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 15MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:180 /30Days |
MORPHINE SULFATE 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:180 /30Days |
MORPHINE SULFATE 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE INJECTION 1MG 5X10ML VIALGL ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE INJECTION 1MG 5X10ML VIALGL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MORPHINE SULFATE ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MORPHINE SULFATE ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MORPHINE SULFATE TABLET ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE TABLET ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | Q:180 /30Days |
MORPHINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MORPHINE SULFATE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
Multaq 400mg/1 60 TABLET, FILM COATED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Multaq 400mg/1 60 TABLET, FILM COATED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | Q:60 /30Days |
MUPIROCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover MUPIROCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$9.00 | N/A | None |
MYCOBUTIN 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MYCOBUTIN 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |
Mycophenolate Mofetil 250mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Mycophenolate Mofetil 250mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | P |
MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT ![Compare how all Medicare Part D PDP plans in WI cover MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Tier 2 |
$33.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MYFORTIC 180MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MYFORTIC 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MYFORTIC 360MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MYFORTIC 360MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | P |
MYOZYME 50MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover MYOZYME 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
MYTELASE 10MG CAPLET ![Compare how all Medicare Part D PDP plans in WI cover MYTELASE 10MG CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$95.00 | N/A | None |