2017 Medicare Part D Plan Formulary Information |
Aetna Medicare Innovation Prime Plan (HMO) (H3931-096-0)
Benefit Details
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The Aetna Medicare Innovation Prime Plan (HMO) (H3931-096-0) Formulary Drugs Starting with the Letter P in Spotsylvania County, VA: CMS MA Region 7 which includes: VA Plan Monthly Premium: $59.00 Deductible: $300 |
Drugs Starting with Letter P
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
PACERONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PACERONE 200MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PACERONE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PACERONE 400MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PACERONE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD ![Compare how all Medicare Part D PDP plans in VA cover PACLITAXEL INJECTION SOLUTION 6MG 50ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PALIPERIDONE ER 1.5 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in VA cover PALIPERIDONE ER 1.5 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:30 /30Days |
PALIPERIDONE ER 3 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in VA cover PALIPERIDONE ER 3 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:30 /30Days |
PALIPERIDONE ER 6 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in VA cover PALIPERIDONE ER 6 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:60 /30Days |
PALIPERIDONE ER 9 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in VA cover PALIPERIDONE ER 9 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:30 /30Days |
PAMIDRONATE 60MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover PAMIDRONATE 60MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in VA cover PAMIDRONATE DISODIUM INJECTION 3MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD ![Compare how all Medicare Part D PDP plans in VA cover PAMIDRONATE DISODIUM INJECTION 9MG 10ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in VA cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | None |
Pantoprazole 40mg/1 90 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Pantoprazole 40mg/1 90 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:60 /30Days |
PANTOPRAZOLE SODIUM 20 MG TABLET DELAYED RELEASE ![Compare how all Medicare Part D PDP plans in VA cover PANTOPRAZOLE SODIUM 20 MG TABLET DELAYED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:30 /30Days |
PANTOPRAZOLE SODIUM 40 MG VIAL ![Compare how all Medicare Part D PDP plans in VA cover PANTOPRAZOLE SODIUM 40 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Paricalcitol 0.005 MG/ML Injectable Solution [Zemplar] ![Compare how all Medicare Part D PDP plans in VA cover Paricalcitol 0.005 MG/ML Injectable Solution [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PARICALCITOL 1 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in VA cover PARICALCITOL 1 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Paricalcitol 1 ML 0.002 MG/ML Injection [Zemplar] ![Compare how all Medicare Part D PDP plans in VA cover Paricalcitol 1 ML 0.002 MG/ML Injection [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PARICALCITOL 2 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in VA cover PARICALCITOL 2 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PARICALCITOL 4 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in VA cover PARICALCITOL 4 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PAROMOMYCIN 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PAROMOMYCIN 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Paroxetine 40mg/1 500 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Paroxetine 40mg/1 500 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PAROXETINE FILM COATED 20MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover PAROXETINE FILM COATED 20MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Paroxetine hcl 30 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Paroxetine hcl 30 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PAROXETINE HCL TABLET 24 12.5MG ![Compare how all Medicare Part D PDP plans in VA cover PAROXETINE HCL TABLET 24 12.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days |
PAROXETINE HCL TABLET 24 25MG ![Compare how all Medicare Part D PDP plans in VA cover PAROXETINE HCL TABLET 24 25MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days |
Paroxetine Hydrochloride 37.5mg/1 30 BOTTLE in 1 BOTTLE / 30 TABLET, FILM COATED, EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in VA cover Paroxetine Hydrochloride 37.5mg/1 30 BOTTLE in 1 BOTTLE / 30 TABLET, FILM COATED, EXTENDED RELEASE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days |
PAROXETINE HYDROCHLORIDE TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in VA cover PAROXETINE HYDROCHLORIDE TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in VA cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PATADAY 0.2% DROPS ![Compare how all Medicare Part D PDP plans in VA cover PATADAY 0.2% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PATANASE 665ug/1 240 SPRAY, METERED in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover PATANASE 665ug/1 240 SPRAY, METERED in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:31 /30Days |
PAXIL ORAL SUSPENSION 10 MG/5ML ![Compare how all Medicare Part D PDP plans in VA cover PAXIL ORAL SUSPENSION 10 MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAZEO 0.7% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PAZEO 0.7% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PCE 333 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PCE 333 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PCE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PCE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PEDIARIX 0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in VA cover PEDIARIX 0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in VA cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PEG 3350-ELECTROLYTE SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PEG 3350-ELECTROLYTE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PEG-3350 and Electrolytes 236; 2.97; 6.74; 5.86; 22.74g/2L; g/2L; g/2L; g/2L; g/2L 4 L in 1 JUG ![Compare how all Medicare Part D PDP plans in VA cover PEG-3350 and Electrolytes 236; 2.97; 6.74; 5.86; 22.74g/2L; g/2L; g/2L; g/2L; g/2L 4 L in 1 JUG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PEGANONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PEGANONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PegIntron 120ug/0.5mL 1 CARTRIDGE per CARTON / 0.5 mL in 1 CARTRIDGE ![Compare how all Medicare Part D PDP plans in VA cover PegIntron 120ug/0.5mL 1 CARTRIDGE per CARTON / 0.5 mL in 1 CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P |
PEGINTRON 50 MCG KIT ![Compare how all Medicare Part D PDP plans in VA cover PEGINTRON 50 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P |
PENICILLIN G POTASSIUM FOR INJECTION 5000000UNIT/VIAL ![Compare how all Medicare Part D PDP plans in VA cover PENICILLIN G POTASSIUM FOR INJECTION 5000000UNIT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in VA cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Penicillin G Sodium 5000000[iU]/1 10 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in VA cover Penicillin G Sodium 5000000[iU]/1 10 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Penicillin V Potassium 125mg/5mL 200 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Penicillin V Potassium 125mg/5mL 200 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Penicillin V Potassium 250mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Penicillin V Potassium 250mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in VA cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PENTAM 300 INJ 300MG ![Compare how all Medicare Part D PDP plans in VA cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in VA cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in VA cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PERFOROMIST 20MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in VA cover PERFOROMIST 20MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Perindopril Erbumine 2mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Perindopril Erbumine 2mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Perindopril Erbumine 4mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Perindopril Erbumine 4mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Perindopril Erbumine 8mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Perindopril Erbumine 8mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PERIOGARD 0.12% ORAL RINSE ![Compare how all Medicare Part D PDP plans in VA cover PERIOGARD 0.12% ORAL RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PERJETA 420 MG/14 ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover PERJETA 420 MG/14 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P |
Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in VA cover Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Perphenazine 16mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Perphenazine 16mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PERPHENAZINE TABLETS 4MG 100 BOXUD ![Compare how all Medicare Part D PDP plans in VA cover PERPHENAZINE TABLETS 4MG 100 BOXUD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PERPHENAZINE TABLETS 8MG 100 BOT ![Compare how all Medicare Part D PDP plans in VA cover PERPHENAZINE TABLETS 8MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PERPHENAZINE TABLETS USP 2MG 100 BOT ![Compare how all Medicare Part D PDP plans in VA cover PERPHENAZINE TABLETS USP 2MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PHENADOZ 12.5 MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in VA cover PHENADOZ 12.5 MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Phenergan 12.5 mg suppository ![Compare how all Medicare Part D PDP plans in VA cover Phenergan 12.5 mg suppository.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
Phenergan 25 mg suppository ![Compare how all Medicare Part D PDP plans in VA cover Phenergan 25 mg suppository.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
Phenergan 50 mg suppository ![Compare how all Medicare Part D PDP plans in VA cover Phenergan 50 mg suppository.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
Phenobarbital 100mg/1 ![Compare how all Medicare Part D PDP plans in VA cover Phenobarbital 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
Phenobarbital 15mg/1 ![Compare how all Medicare Part D PDP plans in VA cover Phenobarbital 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
PHENOBARBITAL 16.2 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PHENOBARBITAL 16.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
PHENOBARBITAL 20 MG/5 ML ELIX ![Compare how all Medicare Part D PDP plans in VA cover PHENOBARBITAL 20 MG/5 ML ELIX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:1500 /30Days |
Phenobarbital 30mg/1 ![Compare how all Medicare Part D PDP plans in VA cover Phenobarbital 30mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
PHENOBARBITAL 32.4 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PHENOBARBITAL 32.4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
Phenobarbital 60mg/1 ![Compare how all Medicare Part D PDP plans in VA cover Phenobarbital 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENOBARBITAL 64.8 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PHENOBARBITAL 64.8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
PHENOBARBITAL 97.2 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PHENOBARBITAL 97.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:120 /30Days |
Phenoxybenzamine HCl 10 MG Oral Capsule [Dibenzyline] ![Compare how all Medicare Part D PDP plans in VA cover Phenoxybenzamine HCl 10 MG Oral Capsule [Dibenzyline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
phenytoin 50 mg tablet chew ![Compare how all Medicare Part D PDP plans in VA cover phenytoin 50 mg tablet chew.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in VA cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PHENYTOIN SODIUM 100MG /2ML INJECTION ![Compare how all Medicare Part D PDP plans in VA cover PHENYTOIN SODIUM 100MG /2ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PHENYTOIN SODIUM EXT 200 MG CAP ![Compare how all Medicare Part D PDP plans in VA cover PHENYTOIN SODIUM EXT 200 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PHENYTOIN SODIUM EXT 300 MG CAP ![Compare how all Medicare Part D PDP plans in VA cover PHENYTOIN SODIUM EXT 300 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover PHENYTOIN SODIUM EXTENDED CAPSULES 100MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PHOSPHOLINE IODIDE 0.125% 6.25MG ![Compare how all Medicare Part D PDP plans in VA cover PHOSPHOLINE IODIDE 0.125% 6.25MG .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PHYSIOLYTE SOLUTION FOR IRRIGATION ![Compare how all Medicare Part D PDP plans in VA cover PHYSIOLYTE SOLUTION FOR IRRIGATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHYSIOSOL IRRIGATION SOL ![Compare how all Medicare Part D PDP plans in VA cover PHYSIOSOL IRRIGATION SOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PILOCARPINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PILOCARPINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PILOCARPINE 2% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PILOCARPINE 2% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PILOCARPINE 4% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PILOCARPINE 4% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PILOCARPINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PILOCARPINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PILOCARPINE HCL 7.5 MG 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover PILOCARPINE HCL 7.5 MG 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PIMOZIDE 1 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in VA cover PIMOZIDE 1 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PIMOZIDE 2 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in VA cover PIMOZIDE 2 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PIMTREA 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in VA cover PIMTREA 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PINDOLOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PINDOLOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PINDOLOL 5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PINDOLOL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
pioglitaz-glimepir 30-2 mg tab ![Compare how all Medicare Part D PDP plans in VA cover pioglitaz-glimepir 30-2 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:30 /30Days |
pioglitaz-glimepir 30-4 mg tab ![Compare how all Medicare Part D PDP plans in VA cover pioglitaz-glimepir 30-4 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:30 /30Days |
pioglitazone hcl 15 mg tablet [Actos] ![Compare how all Medicare Part D PDP plans in VA cover pioglitazone hcl 15 mg tablet [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:30 /30Days |
pioglitazone hcl 30 mg tablet [Actos] ![Compare how all Medicare Part D PDP plans in VA cover pioglitazone hcl 30 mg tablet [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:30 /30Days |
pioglitazone hcl 45 mg tablet [Actos] ![Compare how all Medicare Part D PDP plans in VA cover pioglitazone hcl 45 mg tablet [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | Q:30 /30Days |
PIOGLITAZONE-METFORMIN 15-500 ![Compare how all Medicare Part D PDP plans in VA cover PIOGLITAZONE-METFORMIN 15-500.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:90 /30Days |
PIOGLITAZONE-METFORMIN 15-850 ![Compare how all Medicare Part D PDP plans in VA cover PIOGLITAZONE-METFORMIN 15-850.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | Q:90 /30Days |
PIPERACILLIN 200 MG/ML / TAZOBACTAM 25 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PIPERACILLIN 200 MG/ML / TAZOBACTAM 25 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Piperacillin and Tazobactam 4; 0.5g/1; g/1 10 VIAL, SINGLE-USE per CARTON / 1 INJECTION, POWDER, L ![Compare how all Medicare Part D PDP plans in VA cover Piperacillin and Tazobactam 4; 0.5g/1; g/1 10 VIAL, SINGLE-USE per CARTON / 1 INJECTION, POWDER, L.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Pirmella 1-35-28 tablet ![Compare how all Medicare Part D PDP plans in VA cover Pirmella 1-35-28 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PIROXICAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PIROXICAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Piroxicam 20mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Piroxicam 20mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in VA cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT) ![Compare how all Medicare Part D PDP plans in VA cover POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1% ![Compare how all Medicare Part D PDP plans in VA cover POLYMYXIN B SUL-TRIMETHOPRIM 10K U-0.1%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
POMALYST 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover POMALYST 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:21 /22Days |
POMALYST 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover POMALYST 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:21 /22Days |
POMALYST 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover POMALYST 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:21 /22Days |
POMALYST 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover POMALYST 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:21 /22Days |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in VA cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225% ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE 40MEQ/NS 1000ML IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE 750MG EXTENDED RELEASE TABLETS ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE 750MG EXTENDED RELEASE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POTASSIUM CHLORIDE ER CAPSULES 10MEQ ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE ER CAPSULES 10MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POTASSIUM CHLORIDE ER CPCR 8MEQ ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE ER CPCR 8MEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND NACL SOLUTION FOR INJECTION 0.075% 1000ML PLASTIC BAGS X 12 CA ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND NACL SOLUTION FOR INJECTION 0.075% 1000ML PLASTIC BAGS X 12 CA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in VA cover Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.33g/100mL; g/100mL; g/100mL 12 CONTAI ![Compare how all Medicare Part D PDP plans in VA cover Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.33g/100mL; g/100mL; g/100mL 12 CONTAI.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.45g/100mL; g/100mL; g/100mL 12 CONTAI ![Compare how all Medicare Part D PDP plans in VA cover Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.45g/100mL; g/100mL; g/100mL 12 CONTAI.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i ![Compare how all Medicare Part D PDP plans in VA cover Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Potassium Chloride in Lactated Ringers and Dextrose 20; 5; 179; 600; 310mg/100mL; g/100mL; mg/100mL ![Compare how all Medicare Part D PDP plans in VA cover Potassium Chloride in Lactated Ringers and Dextrose 20; 5; 179; 600; 310mg/100mL; g/100mL; mg/100mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POTASSIUM CHLORIDE INJECTION 10MEQ/100ML ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE INJECTION 10MEQ/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE INJECTION 20 MEQ/100ML ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE INJECTION 20 MEQ/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CHLORIDE INJECTION 40 MEQ/100ML ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CHLORIDE INJECTION 40 MEQ/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CITRATE ER 10 MEQ TB ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CITRATE ER 10 MEQ TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CITRATE ER 15 MEQ TABLET ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CITRATE ER 15 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CITRATE ER 5 MEQ TAB ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CITRATE ER 5 MEQ TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CITRATE ER 8 MEQ TABLET ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CITRATE ER 8 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Potassium cl 10% (20 meq/15 ml) ![Compare how all Medicare Part D PDP plans in VA cover Potassium cl 10% (20 meq/15 ml).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Potassium cl 2 meq/ml vial ![Compare how all Medicare Part D PDP plans in VA cover Potassium cl 2 meq/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Potassium cl 20% (40 meq/15 ml) ![Compare how all Medicare Part D PDP plans in VA cover Potassium cl 20% (40 meq/15 ml).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CL ER 10 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
POTASSIUM CL ER 20 MEQ TABLET ![Compare how all Medicare Part D PDP plans in VA cover POTASSIUM CL ER 20 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Potassium cl er 20 meq tablet ![Compare how all Medicare Part D PDP plans in VA cover Potassium cl er 20 meq tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PRADAXA 110 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PRADAXA 110 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:60 /30Days |
PRADAXA 150 MG 1 BOTTLE per CARTON / 60 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover PRADAXA 150 MG 1 BOTTLE per CARTON / 60 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:60 /30Days |
PRADAXA 75 MG 1 BOTTLE per CARTON / 60 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover PRADAXA 75 MG 1 BOTTLE per CARTON / 60 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:60 /30Days |
PRALUENT 150 MG/ML PEN ![Compare how all Medicare Part D PDP plans in VA cover PRALUENT 150 MG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:2 /28Days |
PRALUENT 75 MG/ML PEN ![Compare how all Medicare Part D PDP plans in VA cover PRALUENT 75 MG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:2 /28Days |
PRAMIPEXOLE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Pramipexole Dihydrochloride 0.125mg 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Pramipexole Dihydrochloride 0.125mg 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Pramipexole Dihydrochloride 0.25mg 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Pramipexole Dihydrochloride 0.25mg 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Pramipexole Dihydrochloride 0.5mg 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Pramipexole Dihydrochloride 0.5mg 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Pramipexole Dihydrochloride 1.5mg 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Pramipexole Dihydrochloride 1.5mg 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Pramipexole Dihydrochloride 1mg 500 TABLET BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Pramipexole Dihydrochloride 1mg 500 TABLET BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PRAMIPEXOLE ER 0.375 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 0.375 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAMIPEXOLE ER 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAMIPEXOLE ER 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAMIPEXOLE ER 2.25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 2.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAMIPEXOLE ER 3 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAMIPEXOLE ER 3.75 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 3.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAMIPEXOLE ER 4.5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRAMIPEXOLE ER 4.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAVASTATIN SODIUM 20MG TABLET 500 BOT ![Compare how all Medicare Part D PDP plans in VA cover PRAVASTATIN SODIUM 20MG TABLET 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PRAVASTATIN SODIUM 40MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in VA cover PRAVASTATIN SODIUM 40MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Pravastatin Sodium 80mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Pravastatin Sodium 80mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PRAVASTATIN SODIUM TABLETS 10MG 90 BOT ![Compare how all Medicare Part D PDP plans in VA cover PRAVASTATIN SODIUM TABLETS 10MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PRAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PRAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in VA cover PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PRED MILD 0.12% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PRED MILD 0.12% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PRED-G S.O.P. EYE OINTMENT ![Compare how all Medicare Part D PDP plans in VA cover PRED-G S.O.P. EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Prednicarbate 0.1% cream ![Compare how all Medicare Part D PDP plans in VA cover Prednicarbate 0.1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in VA cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Prednisolone 10 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in VA cover Prednisolone 10 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR ![Compare how all Medicare Part D PDP plans in VA cover PREDNISOLONE ACETATE OPHTHALMIC SUSPENSION 1.0% STERILE 10ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in VA cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PREDNISOLONE SOD PH 25 MG/5 ML ![Compare how all Medicare Part D PDP plans in VA cover PREDNISOLONE SOD PH 25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in VA cover PREDNISOLONE SODIUM PHOSPHATE 15MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Prednisone 10 mg tab dose pack ![Compare how all Medicare Part D PDP plans in VA cover Prednisone 10 mg tab dose pack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Prednisone 10 mg tab dose pack ![Compare how all Medicare Part D PDP plans in VA cover Prednisone 10 mg tab dose pack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 20MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 20MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Prednisone 5 mg tab dose pack ![Compare how all Medicare Part D PDP plans in VA cover Prednisone 5 mg tab dose pack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
Prednisone 5 mg tab dose pack ![Compare how all Medicare Part D PDP plans in VA cover Prednisone 5 mg tab dose pack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 5MG/5ML SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 5MG/5ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$2.00 | $4.00 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Premarin 0.625mg/g ![Compare how all Medicare Part D PDP plans in VA cover Premarin 0.625mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREPOPIK POWDER PACKET ![Compare how all Medicare Part D PDP plans in VA cover PREPOPIK POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PREVALITE POW 4GM ![Compare how all Medicare Part D PDP plans in VA cover PREVALITE POW 4GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Previfem 6 BLISTER PACK per BLISTER PACK / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VA cover Previfem 6 BLISTER PACK per BLISTER PACK / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PREZCOBIX 800 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PREZCOBIX 800 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | Q:30 /30Days |
PREZISTA 100 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in VA cover PREZISTA 100 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | None |
PREZISTA 150MG TABLETS ![Compare how all Medicare Part D PDP plans in VA cover PREZISTA 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | None |
PREZISTA 800 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PREZISTA 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | None |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in VA cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in VA cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PRIFTIN 150MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRIFTIN 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Primaquine Phosphate 26.3 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in VA cover Primaquine Phosphate 26.3 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRIMIDONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRIMIDONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Primidone 50mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Primidone 50mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PRISTIQ ER 25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PRISTIQ ER 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | S Q:120 /30Days |
PROAIR HFA 90 MCG INHALER ![Compare how all Medicare Part D PDP plans in VA cover PROAIR HFA 90 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:17 /30Days |
PROAIR RESPICLICK INHAL POWDER ![Compare how all Medicare Part D PDP plans in VA cover PROAIR RESPICLICK INHAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:2 /30Days |
PROBENECID 500MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROBENECID 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PROBENECID/COLCHICINE 0.5MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROBENECID/COLCHICINE 0.5MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Prochlorperazine 10 mg/2 ml vl ![Compare how all Medicare Part D PDP plans in VA cover Prochlorperazine 10 mg/2 ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover PROCHLORPERAZINE MALEATE 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Prochlorperazine Maleate 5mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Prochlorperazine Maleate 5mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in VA cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:12 /28Days |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:12 /28Days |
PROCRIT 3,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover PROCRIT 3,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:12 /28Days |
PROCRIT 4,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover PROCRIT 4,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:12 /28Days |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in VA cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:8 /28Days |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in VA cover PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:12 /28Days |
PROCTO-MED HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in VA cover PROCTO-MED HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
procto-pak 1% cream ![Compare how all Medicare Part D PDP plans in VA cover procto-pak 1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in VA cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
proctozone-hc 2.5% cream ![Compare how all Medicare Part D PDP plans in VA cover proctozone-hc 2.5% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROGESTERONE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PROGESTERONE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROGESTERONE 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PROGESTERONE 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Proglycem 50mg/mL 1 BOTTLE, DROPPER in 1 BOX / 30 mL in 1 BOTTLE, DROPPER ![Compare how all Medicare Part D PDP plans in VA cover Proglycem 50mg/mL 1 BOTTLE, DROPPER in 1 BOX / 30 mL in 1 BOTTLE, DROPPER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROGRAF 5MG/ML AMPULE ![Compare how all Medicare Part D PDP plans in VA cover PROGRAF 5MG/ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
PROLASTIN-C ![Compare how all Medicare Part D PDP plans in VA cover PROLASTIN-C .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P |
PROLENSA 0.07% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PROLENSA 0.07% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROLEUKIN 22 MILLION UNIT VIAL ![Compare how all Medicare Part D PDP plans in VA cover PROLEUKIN 22 MILLION UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | None |
PROLIA 60MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in VA cover PROLIA 60MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:1 /166Days |
PROMACTA 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROMACTA 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:30 /30Days |
PROMACTA 25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROMACTA 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:30 /30Days |
PROMACTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROMACTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:30 /30Days |
PROMACTA 75 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROMACTA 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHAZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHAZINE 50 MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE 50 MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHAZINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHAZINE HCL 6.25MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE HCL 6.25MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in VA cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in VA cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in VA cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | P |
Propafenone HCl 150mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Propafenone HCl 150mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPAFENONE HCL 300MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover PROPAFENONE HCL 300MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PROPAFENONE HCL ER 225 MG CAP ![Compare how all Medicare Part D PDP plans in VA cover PROPAFENONE HCL ER 225 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in VA cover PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in VA cover PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Propantheline Bromide 15mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Propantheline Bromide 15mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPARACAINE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover PROPARACAINE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PROPRANOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Propranolol 1mg/mL 1 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in VA cover Propranolol 1mg/mL 1 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPRANOLOL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPRANOLOL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
Propranolol 60 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Propranolol 60 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPRANOLOL 80 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPRANOLOL ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROPRANOLOL ER 160 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL ER 160 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROPRANOLOL ER 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL ER 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROPRANOLOL ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $15.00 | None |
PROQUAD 0.5 VIAL ![Compare how all Medicare Part D PDP plans in VA cover PROQUAD 0.5 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROTRIPTYLINE HYDROCHLORIDE 10MG TABLETS ![Compare how all Medicare Part D PDP plans in VA cover PROTRIPTYLINE HYDROCHLORIDE 10MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG ![Compare how all Medicare Part D PDP plans in VA cover PROTRIPTYLINE HYDROCHLORIDE TABLETS 5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in VA cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:2 /30Days |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in VA cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:2 /30Days |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in VA cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P |
PURIXAN 20 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in VA cover PURIXAN 20 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
27% | N/A | P |
PYRAZINAMIDE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover PYRAZINAMIDE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Pyridostigmine br 60 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Pyridostigmine br 60 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
PYRIDOSTIGMINE BR ER 180 MG TAB ![Compare how all Medicare Part D PDP plans in VA cover PYRIDOSTIGMINE BR ER 180 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |