2015 Medicare Part D Plan Formulary Information |
EnvisionRxPlus Silver (PDP) (S7694-070-0)
Benefit Details
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The EnvisionRxPlus Silver (PDP) (S7694-070-0) Formulary Drugs Starting with the Letter S in CMS PDP Region 13 which includes: MI Plan Monthly Premium: $31.10 Deductible: $320 Qualifies for LIS: Yes |
Drugs Starting with Letter S
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
SANDIMMUNE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SANDIMMUNE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SANDIMMUNE 100MG/ML TUBEX ![Compare how all Medicare Part D PDP plans in MI cover SANDIMMUNE 100MG/ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SANDIMMUNE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SANDIMMUNE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SAPHRIS 10 MG TAB SL BLK CHERY ![Compare how all Medicare Part D PDP plans in MI cover SAPHRIS 10 MG TAB SL BLK CHERY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
SAPHRIS 2.5 MG TAB SL BLK CHRY ![Compare how all Medicare Part D PDP plans in MI cover SAPHRIS 2.5 MG TAB SL BLK CHRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
SAPHRIS 5 MG TAB SL BLK CHERRY ![Compare how all Medicare Part D PDP plans in MI cover SAPHRIS 5 MG TAB SL BLK CHERRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
SAVELLA TABLETS 100MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MI cover SAVELLA TABLETS 100MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SAVELLA TABLETS 12.5MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MI cover SAVELLA TABLETS 12.5MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SAVELLA TABLETS 25MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MI cover SAVELLA TABLETS 25MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM ![Compare how all Medicare Part D PDP plans in MI cover SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SAVELLA TALBETS 50MG 60 COUNT BOT ![Compare how all Medicare Part D PDP plans in MI cover SAVELLA TALBETS 50MG 60 COUNT BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SECONAL SODIUM 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SECONAL SODIUM 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SELEGILINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SELEGILINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SELEGILINE HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SELEGILINE HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SELZENTRY 150mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:240 /30Days |
SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SELZENTRY 300mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:120 /30Days |
SENSIPAR 30MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SENSIPAR 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SENSIPAR 60MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SENSIPAR 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | None |
SENSIPAR 90MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SENSIPAR 90MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | None |
SEREVENT DIS AER 50MCG ![Compare how all Medicare Part D PDP plans in MI cover SEREVENT DIS AER 50MCG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SEROQUEL TABLETS EXTENDED RELEASE 150MG 100 CRTN ![Compare how all Medicare Part D PDP plans in MI cover SEROQUEL TABLETS EXTENDED RELEASE 150MG 100 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SEROQUEL TABLETS EXTENDED RELEASE 200MG 100 X 200 MG CRTN ![Compare how all Medicare Part D PDP plans in MI cover SEROQUEL TABLETS EXTENDED RELEASE 200MG 100 X 200 MG CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SEROQUEL TABLETS EXTENDED RELEASE 400MG 100 X 400 MG CRTN ![Compare how all Medicare Part D PDP plans in MI cover SEROQUEL TABLETS EXTENDED RELEASE 400MG 100 X 400 MG CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SEROQUEL TABLETS EXTENDED RELEASE 50MG 100 TABS CRTN ![Compare how all Medicare Part D PDP plans in MI cover SEROQUEL TABLETS EXTENDED RELEASE 50MG 100 TABS CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SEROQUEL XR 300MG TABLET 60X300MG BOT ![Compare how all Medicare Part D PDP plans in MI cover SEROQUEL XR 300MG TABLET 60X300MG BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SERTRALINE HCL 100MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MI cover SERTRALINE HCL 100MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SERTRALINE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SERTRALINE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SERTRALINE HCL 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MI cover SERTRALINE HCL 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SERTRALINE HYDROCHLORIDE 20MG/ML ORAL CONCENTRATE ![Compare how all Medicare Part D PDP plans in MI cover SERTRALINE HYDROCHLORIDE 20MG/ML ORAL CONCENTRATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA] ![Compare how all Medicare Part D PDP plans in MI cover SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA] ![Compare how all Medicare Part D PDP plans in MI cover SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Signifor .3 mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Signifor .3 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
Signifor .6 mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Signifor .6 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
Signifor .9 mg/mL ![Compare how all Medicare Part D PDP plans in MI cover Signifor .9 mg/mL .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SIGNIFOR LAR 20 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SIGNIFOR LAR 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SIGNIFOR LAR 40 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SIGNIFOR LAR 40 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SIGNIFOR LAR 60 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SIGNIFOR LAR 60 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SILDENAFIL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SILDENAFIL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:90 /30Days |
SILENOR 3 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SILENOR 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SILENOR 6 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SILENOR 6 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SILVER SULFADIAZINE 1% CRM ![Compare how all Medicare Part D PDP plans in MI cover SILVER SULFADIAZINE 1% CRM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SIMBRINZA 1%-0.2% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover SIMBRINZA 1%-0.2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIMVASTATIN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SIMVASTATIN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:30 /30Days |
SIMVASTATIN 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SIMVASTATIN 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:30 /30Days |
SIMVASTATIN 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover SIMVASTATIN 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:30 /30Days |
SIMVASTATIN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SIMVASTATIN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:30 /30Days |
SIMVASTATIN 80MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MI cover SIMVASTATIN 80MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:30 /30Days |
Sirolimus 0.5 MG Tablet [Rapamune] ![Compare how all Medicare Part D PDP plans in MI cover Sirolimus 0.5 MG Tablet [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SIROLIMUS 1 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in MI cover SIROLIMUS 1 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SIROLIMUS 2 MG TABLET [Rapamune] ![Compare how all Medicare Part D PDP plans in MI cover SIROLIMUS 2 MG TABLET [Rapamune].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SODIUM CHLORIDE 0.45% TUBEX ![Compare how all Medicare Part D PDP plans in MI cover SODIUM CHLORIDE 0.45% TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sodium Chloride 3g/100mL ![Compare how all Medicare Part D PDP plans in MI cover Sodium Chloride 3g/100mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sodium Chloride 900mg/100mL 9 BOTTLE, PLASTIC in 1 CASE / 1500 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Sodium Chloride 900mg/100mL 9 BOTTLE, PLASTIC in 1 CASE / 1500 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Sodium Chloride 9g/1000mL 4 BAG in 1 PACKAGE / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in MI cover Sodium Chloride 9g/1000mL 4 BAG in 1 PACKAGE / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SODIUM CHLORIDE INJECTION USP 5% ![Compare how all Medicare Part D PDP plans in MI cover SODIUM CHLORIDE INJECTION USP 5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SODIUM CL 2.5 MEQ/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover SODIUM CL 2.5 MEQ/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SODIUM PHENYLBUTYRATE POWDER ![Compare how all Medicare Part D PDP plans in MI cover SODIUM PHENYLBUTYRATE POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
sodium polystyrene sulf pwd ![Compare how all Medicare Part D PDP plans in MI cover sodium polystyrene sulf pwd.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SOLTAMOX 10 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in MI cover SOLTAMOX 10 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SOMATULINE 60 MG/0.2 ML SYRING ![Compare how all Medicare Part D PDP plans in MI cover SOMATULINE 60 MG/0.2 ML SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
Somatuline Depot 90mg/0.3mL 1 POUCH per CARTON / 1 SYRINGE in 1 POUCH / 0.3 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover Somatuline Depot 90mg/0.3mL 1 POUCH per CARTON / 1 SYRINGE in 1 POUCH / 0.3 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SOMAVERT 10 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SOMAVERT 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SOMAVERT 15 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SOMAVERT 15 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SOMAVERT 20 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SOMAVERT 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MI cover SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MI cover SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MI cover SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in MI cover SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SOTALOL HCL TABLET 240MG ![Compare how all Medicare Part D PDP plans in MI cover SOTALOL HCL TABLET 240MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sotalol Hydrochloride 120mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Sotalol Hydrochloride 120mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
sotalol hydrochloride 160mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover sotalol hydrochloride 160mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sotalol Hydrochloride 80mg/1 100 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in MI cover Sotalol Hydrochloride 80mg/1 100 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SOVALDI 400 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SOVALDI 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SPIRIVA 18MCG CP-HANDIHALER 90 (9 X 10) BLPK ![Compare how all Medicare Part D PDP plans in MI cover SPIRIVA 18MCG CP-HANDIHALER 90 (9 X 10) BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:30 /30Days |
SPIRIVA RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SPIRIVA RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:4 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPIRONOLACTONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPIRONOLACTONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SPIRONOLACTONE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover SPIRONOLACTONE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SPIRONOLACTONE 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover SPIRONOLACTONE 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SPIRONOLACTONE/HCTZ TABLET 25-25MG (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover SPIRONOLACTONE/HCTZ TABLET 25-25MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SPRYCEL 100mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:60 /30Days |
SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SPRYCEL 140mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:30 /30Days |
SPRYCEL 20MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRYCEL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:90 /30Days |
SPRYCEL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRYCEL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:60 /30Days |
SPRYCEL 70MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRYCEL 70MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:60 /30Days |
SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SPRYCEL 80mg/1 1 BOTTLE per CARTON / 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:60 /30Days |
SSD Cream 10g/1000g 85 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MI cover SSD Cream 10g/1000g 85 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
STAVUDINE 1 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover STAVUDINE 1 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
STAVUDINE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in MI cover STAVUDINE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:120 /30Days |
STAVUDINE CAPSULES 20MG 60 BOT ![Compare how all Medicare Part D PDP plans in MI cover STAVUDINE CAPSULES 20MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:120 /30Days |
STAVUDINE CAPSULES 30MG 60 BOT ![Compare how all Medicare Part D PDP plans in MI cover STAVUDINE CAPSULES 30MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:60 /30Days |
STAVUDINE CAPSULES 40MG 60 BOT ![Compare how all Medicare Part D PDP plans in MI cover STAVUDINE CAPSULES 40MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:60 /30Days |
STERILE WATER FOR IRRIGATION ![Compare how all Medicare Part D PDP plans in MI cover STERILE WATER FOR IRRIGATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
STIVARGA 40 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover STIVARGA 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
STRATTERA 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
STRATTERA 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
STRATTERA 18MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 18MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
STRATTERA 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
STRATTERA 40MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 40MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
STRATTERA 60MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 60MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
STRATTERA 80MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover STRATTERA 80MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | S |
STREPTOMYCIN FOR INJECTION 1GM/VIL ![Compare how all Medicare Part D PDP plans in MI cover STREPTOMYCIN FOR INJECTION 1GM/VIL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
STRIBILD TABLET ![Compare how all Medicare Part D PDP plans in MI cover STRIBILD TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:30 /30Days |
SUBOXONE 12 MG-3 MG SL FILM ![Compare how all Medicare Part D PDP plans in MI cover SUBOXONE 12 MG-3 MG SL FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
Suboxone 2; 0.5mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH ![Compare how all Medicare Part D PDP plans in MI cover Suboxone 2; 0.5mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SUBOXONE 4 MG-1 MG SL FILM ![Compare how all Medicare Part D PDP plans in MI cover SUBOXONE 4 MG-1 MG SL FILM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
Suboxone 8; 2mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH ![Compare how all Medicare Part D PDP plans in MI cover Suboxone 8; 2mg/1; mg/1 30 POUCH per CARTON / 1 FILM, SOLUBLE in 1 POUCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | None |
SUBSYS 1,200 MCG SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SUBSYS 1,200 MCG SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:180 /30Days |
SUBSYS 100 MCG SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SUBSYS 100 MCG SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUBSYS 200 MCG SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SUBSYS 200 MCG SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:180 /30Days |
SUBSYS 400 MCG SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SUBSYS 400 MCG SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:180 /30Days |
SUBSYS 800 MCG SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SUBSYS 800 MCG SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:180 /30Days |
SUCRALFATE 1GM TABLET ![Compare how all Medicare Part D PDP plans in MI cover SUCRALFATE 1GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SULFACETAMIDE 10% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover SULFACETAMIDE 10% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
Sulfacetamide Sodium 100mg/mL 118 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Sulfacetamide Sodium 100mg/mL 118 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT ![Compare how all Medicare Part D PDP plans in MI cover SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SULFACETAMIDE-PREDNISOLONE 10-0.25% DROPS ![Compare how all Medicare Part D PDP plans in MI cover SULFACETAMIDE-PREDNISOLONE 10-0.25% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sulfadiazine 500mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Sulfadiazine 500mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
Sulfamethoxazole and Trimethoprim 200; 40mg/5mL; mg/5mL ![Compare how all Medicare Part D PDP plans in MI cover Sulfamethoxazole and Trimethoprim 200; 40mg/5mL; mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sulfamethoxazole and Trimethoprim 800; 160mg/1; mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Sulfamethoxazole and Trimethoprim 800; 160mg/1; mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SULFAMETHOXAZOLE W/TMP VIAL 80MG-16ML 10 X 10ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover SULFAMETHOXAZOLE W/TMP VIAL 80MG-16ML 10 X 10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SULFAMETHOXAZOLE-TRIMETHOPRIM TABLET 400-80MG (500 CT) ![Compare how all Medicare Part D PDP plans in MI cover SULFAMETHOXAZOLE-TRIMETHOPRIM TABLET 400-80MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SULFASALAZINE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SULFASALAZINE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SULFAZINE EC 500MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover SULFAZINE EC 500MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SULINDAC 150MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MI cover SULINDAC 150MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
SULINDAC 200MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SULINDAC 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | None |
Sumatriptan 6 mg/0.5 ml vial ![Compare how all Medicare Part D PDP plans in MI cover Sumatriptan 6 mg/0.5 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:8 /30Days |
Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MI cover Sumatriptan Succinate 25mg/1 9 BLISTER PACK per CARTON / 9 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:9 /30Days |
Sumatriptan Succinate 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover Sumatriptan Succinate 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:9 /30Days |
Sumatriptan Succinate 6mg/0.5mL 2 SYRINGE in 1 PACKAGE / 0.5 mL in 1 SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover Sumatriptan Succinate 6mg/0.5mL 2 SYRINGE in 1 PACKAGE / 0.5 mL in 1 SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:5 /30Days |
SUMATRIPTAN SUCCINATE TABLETS 100MG 9 BOXUD ![Compare how all Medicare Part D PDP plans in MI cover SUMATRIPTAN SUCCINATE TABLETS 100MG 9 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $6.00 | Q:9 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUPRAX 400 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SUPRAX 400 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SURMONTIL 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SURMONTIL 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SURMONTIL 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SURMONTIL 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
Surmontil 50mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Surmontil 50mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SUSTIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SUSTIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:120 /30Days |
SUSTIVA 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SUSTIVA 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:480 /30Days |
SUSTIVA 600MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SUSTIVA 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | Q:30 /30Days |
SUTENT 12.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SUTENT 12.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:28 /28Days |
SUTENT 25mg/1 28 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover SUTENT 25mg/1 28 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:28 /28Days |
SUTENT 37.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SUTENT 37.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:28 /28Days |
SUTENT 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SUTENT 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYLATRON 296 MCG KIT 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MI cover SYLATRON 296 MCG KIT 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SYLATRON 444 MCG KIT 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MI cover SYLATRON 444 MCG KIT 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SYLATRON 888 MCG KIT 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in MI cover SYLATRON 888 MCG KIT 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER ![Compare how all Medicare Part D PDP plans in MI cover SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:10 /30Days |
SYMBICORT 80; 4.5ug/1; ug/1 1 POUCH in 1 CARTON / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER ![Compare how all Medicare Part D PDP plans in MI cover SYMBICORT 80; 4.5ug/1; ug/1 1 POUCH in 1 CARTON / 1 CANISTER in 1 POUCH / 120 AEROSOL in 1 CANISTER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | Q:10 /30Days |
SYNAGIS 50MG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover SYNAGIS 50MG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
15% | 15% | P |
SYNAREL 2MG/ML NASAL SPRAY ![Compare how all Medicare Part D PDP plans in MI cover SYNAREL 2MG/ML NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | P |
SYNERCID 500MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SYNERCID 500MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SYNRIBO 3.5 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover SYNRIBO 3.5 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |
SYNTHROID 100MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 100MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 112 MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 112 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SYNTHROID 125MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 125MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
Synthroid 137ug/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Synthroid 137ug/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 150MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 150MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 175MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 175MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 200MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 200MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 25MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 25MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 300MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 300MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 50MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 50MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 75MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 75MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYNTHROID 88 MCG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SYNTHROID 88 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
37% | 37% | None |
SYPRINE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SYPRINE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | N/A | P |