2014 Medicare Part D Plan Formulary Information |
Humana Gold Choice H8145-006 (PFFS) (H8145-006-0)
Benefit Details
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The Humana Gold Choice H8145-006 (PFFS) (H8145-006-0) Formulary Drugs Starting with the Letter M in VILAS County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $82.00 Deductible: $0 |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
mafenide acetate 50 gm powd pk ![Compare how all Medicare Part D PDP plans in WI cover mafenide acetate 50 gm powd pk.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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 |
Non-Preferred Brand |
$95.00 | $275.00 | 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 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
Malathion 5mg/mL 1 BOTTLE per CARTON / 59 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Malathion 5mg/mL 1 BOTTLE per CARTON / 59 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
MARLISSA-28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover MARLISSA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
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 WI cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
5 |
Specialty Tier |
33% | N/A | None |
MAVIK 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAVIK 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MAVIK 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAVIK 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MAVIK 4MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAVIK 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
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 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MAXZIDE 37.5 MG-25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MAXZIDE 37.5 MG-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MAXZIDE 50; 75mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover MAXZIDE 50; 75mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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 WI cover MECLOFENAMATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
MEDROL 16MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEDROL 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MEDROL 32MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEDROL 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MEDROL 4MG DOSEPAK ![Compare how all Medicare Part D PDP plans in WI cover MEDROL 4MG DOSEPAK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MEDROL 4MG DOSEPAK (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover MEDROL 4MG DOSEPAK (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MEDROL 8MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEDROL 8MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
Medroxyprogesterone Acetate 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Medroxyprogesterone Acetate 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
Medroxyprogesterone Acetate 2.5mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Medroxyprogesterone Acetate 2.5mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
Medroxyprogesterone Acetate 5mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Medroxyprogesterone Acetate 5mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:1 /90Days |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
Megestrol Acetate 40mg/mL 480 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Megestrol Acetate 40mg/mL 480 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
MEKINIST 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEKINIST 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
MEKINIST 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MEKINIST 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
MELOXICAM 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MELOXICAM 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:30 /30Days |
MELOXICAM 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MELOXICAM 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:60 /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) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:300 /30Days |
MELPHALAN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MELPHALAN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL ![Compare how all Medicare Part D PDP plans in WI cover Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MENOSTAR 14 MCG/DAY PATCH ![Compare how all Medicare Part D PDP plans in WI cover MENOSTAR 14 MCG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:8 /28Days |
MENTAX 1% CREAM 15G TUBE ![Compare how all Medicare Part D PDP plans in WI cover MENTAX 1% CREAM 15G TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
MEROPENEM 500MG/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover MEROPENEM 500MG/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Mesalamine 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in WI cover Mesalamine 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MESNA 100 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover MESNA 100 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MESNEX 100MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in WI cover MESNEX 100MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
METADATE CD 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover METADATE CD 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METADATE CD 20MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover METADATE CD 20MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:60 /30Days |
Metadate CD 30mg EXTENDED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Metadate CD 30mg EXTENDED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:60 /30Days |
METADATE CD 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover METADATE CD 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METADATE CD 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover METADATE CD 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METADATE CD 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover METADATE CD 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /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 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
1 |
Preferred Generic |
$6.00 | $0.00 | 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 |
Preferred Generic |
$6.00 | $0.00 | None |
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 |
Preferred Generic |
$6.00 | $0.00 | None |
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 |
Preferred Generic |
$6.00 | $0.00 | 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 |
Preferred Generic |
$6.00 | $0.00 | Q:60 /30Days |
METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:480 /30Days |
METHADONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover METHADONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:240 /30Days |
Methadone Hydrochloride 10mg/5mL ![Compare how all Medicare Part D PDP plans in WI cover Methadone Hydrochloride 10mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:1800 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Methadone Hydrochloride 5mg/5mL ![Compare how all Medicare Part D PDP plans in WI cover Methadone Hydrochloride 5mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:3600 /30Days |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:360 /30Days |
METHAMPHETAMINE HYDROCHLORIDE TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in WI cover METHAMPHETAMINE HYDROCHLORIDE TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:150 /30Days |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
METHIMAZOLE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHIMAZOLE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
METHIMAZOLE 5MG TABLETS ![Compare how all Medicare Part D PDP plans in WI cover METHIMAZOLE 5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
METHITEST 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHITEST 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Methocarbamol 500mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methocarbamol 500mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
methotrexate 1 gm vial ![Compare how all Medicare Part D PDP plans in WI cover methotrexate 1 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
methotrexate 25 mg/ml vial ![Compare how all Medicare Part D PDP plans in WI cover methotrexate 25 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
METHSCOPOLAMINE BROMIDE 5 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METHSCOPOLAMINE BROMIDE 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
Methylergonovine Maleate 0.2mg/1 28 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methylergonovine Maleate 0.2mg/1 28 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
METHYLIN 10 MG CHEWABLE ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN 10 MG CHEWABLE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:180 /30Days |
METHYLIN 2.5 MG CHEWABLE TAB ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN 2.5 MG CHEWABLE TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:150 /30Days |
METHYLIN 5 MG CHEWABLE TABLET ![Compare how all Medicare Part D PDP plans in WI cover METHYLIN 5 MG CHEWABLE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:150 /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 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:90 /30Days |
METHYLPHENIDATE ER 18 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 18 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METHYLPHENIDATE ER 20 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 20 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METHYLPHENIDATE ER 27 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 27 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METHYLPHENIDATE ER 30 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 30 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:60 /30Days |
METHYLPHENIDATE ER 36 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 36 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:60 /30Days |
METHYLPHENIDATE ER 40 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 40 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
METHYLPHENIDATE ER 54 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE ER 54 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
Methylphenidate Hydrochloride 10mg/5mL 500 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methylphenidate Hydrochloride 10mg/5mL 500 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:900 /30Days |
METHYLPHENIDATE HYDROCHLORIDE 5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE HYDROCHLORIDE 5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:90 /30Days |
Methylphenidate Hydrochloride 5mg/5mL 500 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methylphenidate Hydrochloride 5mg/5mL 500 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:1800 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:90 /30Days |
methylprednisolone 125 mg vial ![Compare how all Medicare Part D PDP plans in WI cover methylprednisolone 125 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
methylprednisolone 40 mg vial ![Compare how all Medicare Part D PDP plans in WI cover methylprednisolone 40 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
Methylprednisolone 40mg/mL 1 VIAL, MULTI-DOSE per 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 per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Methylprednisolone 4mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Methylprednisolone 4mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
Methylprednisolone acetate 80mg/mL 25 VIAL, GLASS per 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 per CARTON / 1 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | P |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Metoclopramide 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Metoclopramide 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
METOPROLOL SUCC ER 100 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCC ER 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:60 /30Days |
METOPROLOL SUCC ER 50 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCC ER 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:60 /30Days |
METOPROLOL SUCCINATE ER 200 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCCINATE ER 200 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:60 /30Days |
METOPROLOL SUCCINATE ER 25 MG TAB ![Compare how all Medicare Part D PDP plans in WI cover METOPROLOL SUCCINATE ER 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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 |
Preferred Generic |
$6.00 | $0.00 | 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) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
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 |
Preferred Generic |
$6.00 | $0.00 | 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 |
Preferred Generic |
$6.00 | $0.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
METROCREAM 0.75% CREAM ![Compare how all Medicare Part D PDP plans in WI cover METROCREAM 0.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
metronidazole 375 mg capsule ![Compare how all Medicare Part D PDP plans in WI cover metronidazole 375 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Metronidazole 500mg/100mL 24 BAG per CARTON / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in WI cover Metronidazole 500mg/100mL 24 BAG per CARTON / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MICROZIDE 12.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MICROZIDE 12.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:8 /30Days |
MINOCYCLINE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MINOCYCLINE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Minocycline Hydrochloride 100mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Minocycline Hydrochloride 100mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
Minocycline Hydrochloride 75mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Minocycline Hydrochloride 75mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
MIRTAZAPINE 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MIRTAZAPINE 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:30 /30Days |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Mirtazapine 45mg/1 500 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Mirtazapine 45mg/1 500 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:30 /30Days |
misoprostol 100 mcg tablet ![Compare how all Medicare Part D PDP plans in WI cover misoprostol 100 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
misoprostol 200 mcg tablet ![Compare how all Medicare Part D PDP plans in WI cover misoprostol 200 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
MITOMYCIN 20 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover MITOMYCIN 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
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 |
Preferred Brand |
$45.00 | $125.00 | None |
MODAFINIL 100 MG TABLET [Provigil] ![Compare how all Medicare Part D PDP plans in WI cover MODAFINIL 100 MG TABLET [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:60 /30Days |
Modicon 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK ![Compare how all Medicare Part D PDP plans in WI cover Modicon 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MOEXIPRIL HCL 15 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MOEXIPRIL HCL 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Moexipril HCL 7.5mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Moexipril HCL 7.5mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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 |
Non-Preferred Generic |
$15.00 | $0.00 | 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 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
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 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
MOMETASONE FUROATE 0.1% OINT ![Compare how all Medicare Part D PDP plans in WI cover MOMETASONE FUROATE 0.1% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
MOMETASONE FUROATE 0.1% SOLN ![Compare how all Medicare Part D PDP plans in WI cover MOMETASONE FUROATE 0.1% SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Mometasone Furoate 1mg/g 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Mometasone Furoate 1mg/g 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MONTELUKAST SOD 10 MG TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in WI cover MONTELUKAST SOD 10 MG TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:30 /30Days |
montelukast sod 4 mg granules [Singulair] ![Compare how all Medicare Part D PDP plans in WI cover montelukast sod 4 mg granules [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
montelukast sod 4 mg tab chew [Singulair] ![Compare how all Medicare Part D PDP plans in WI cover montelukast sod 4 mg tab chew [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
montelukast sod 5 mg tab chew [Singulair] ![Compare how all Medicare Part D PDP plans in WI cover montelukast sod 5 mg tab chew [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | Q:30 /30Days |
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 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Morphine 2 mg/ml isecure syr ![Compare how all Medicare Part D PDP plans in WI cover Morphine 2 mg/ml isecure syr.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:1800 /30Days |
Morphine 4 mg/ml isecure syr ![Compare how all Medicare Part D PDP plans in WI cover Morphine 4 mg/ml isecure syr.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:900 /30Days |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:600 /30Days |
MORPHINE SULFATE 10MG/5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 10MG/5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2700 /30Days |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:120 /30Days |
MORPHINE SULFATE 15MG TABLETS ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 15MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:90 /30Days |
MORPHINE SULFATE 20MG/5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 20MG/5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:1350 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:120 /30Days |
MORPHINE SULFATE 30MG TABLETS ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE 30MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:180 /30Days |
MORPHINE SULFATE ER 10 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 10 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 100 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 120 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 120 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 20 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 20 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 30 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 30 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 30 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 30 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
MORPHINE SULFATE ER 45 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 45 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
MORPHINE SULFATE ER 50 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 50 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 75 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 75 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 80 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 80 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
MORPHINE SULFATE ER 90 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover MORPHINE SULFATE ER 90 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:120 /30Days |
MOVIPREP 7.5-2.691G POWDER IN PACKET ![Compare how all Medicare Part D PDP plans in WI cover MOVIPREP 7.5-2.691G POWDER IN PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MOXEZA 5.45mg/mL 3 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover MOXEZA 5.45mg/mL 3 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MOXIFLOXACIN HCL 400 MG TABLET [Avelox] ![Compare how all Medicare Part D PDP plans in WI cover MOXIFLOXACIN HCL 400 MG TABLET [Avelox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
MOZOBIL 20 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover MOZOBIL 20 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:8 /30Days |
Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
mupirocin 2% cream ![Compare how all Medicare Part D PDP plans in WI cover mupirocin 2% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Non-Preferred Generic |
$15.00 | $0.00 | None |
MUSTARGEN 10 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover MUSTARGEN 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
MYALEPT 11.3 MG (5 MG/ML) VIAL ![Compare how all Medicare Part D PDP plans in WI cover MYALEPT 11.3 MG (5 MG/ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
MYAMBUTOL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MYAMBUTOL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
MYCAMINE 100MG/VIAL FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover MYCAMINE 100MG/VIAL FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
MYCAMINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover MYCAMINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | 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 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Mycophenolate Mofetil 250mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Mycophenolate Mofetil 250mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
Mycophenolic Acid DR 180 mg tb ![Compare how all Medicare Part D PDP plans in WI cover Mycophenolic Acid DR 180 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
Mycophenolic Acid DR 360 mg tb ![Compare how all Medicare Part D PDP plans in WI cover Mycophenolic Acid DR 360 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
MYORISAN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MYORISAN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
MYORISAN 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MYORISAN 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
MYORISAN 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover MYORISAN 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
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 |
Specialty Tier |
33% | N/A | P |
MYRBETRIQ ER 25 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MYRBETRIQ ER 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
MYRBETRIQ ER 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover MYRBETRIQ ER 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |