2017 Medicare Part D Plan Formulary Information |
PriorityMedicare Select (PPO) (H4875-017-3)
Benefit Details
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The PriorityMedicare Select (PPO) (H4875-017-3) Formulary Drugs Starting with the Letter S in Lapeer County, MI: CMS MA Region 11 which includes: MI Plan Monthly Premium: $174.50 Deductible: $0 |
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 |
Safyral 3 BLISTER PACK in 1 PACKAGE / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MI cover Safyral 3 BLISTER PACK in 1 PACKAGE / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN ![Compare how all Medicare Part D PDP plans in MI cover SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:4 /28Days |
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 |
Preferred Brand |
$37.00 | N/A | P |
SANDOSTATIN LAR DEPOT 10 MG KT ![Compare how all Medicare Part D PDP plans in MI cover SANDOSTATIN LAR DEPOT 10 MG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SANDOSTATIN LAR DEPOT 20 MG KT ![Compare how all Medicare Part D PDP plans in MI cover SANDOSTATIN LAR DEPOT 20 MG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SANDOSTATIN LAR DEPOT 30 MG KT ![Compare how all Medicare Part D PDP plans in MI cover SANDOSTATIN LAR DEPOT 30 MG KT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SANTYL OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover SANTYL OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SAVAYSA 15 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SAVAYSA 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:30 /30Days |
SAVAYSA 30 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SAVAYSA 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:30 /30Days |
SAVAYSA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SAVAYSA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:30 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
5 |
Specialty Tier |
33% | N/A | None |
SELZENTRY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SELZENTRY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | None |
SELZENTRY 75 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SELZENTRY 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SEMPREX-D 8 MG-60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SEMPREX-D 8 MG-60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
3 |
Preferred Brand |
$37.00 | N/A | Q:60 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | Q:120 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:30 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:30 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:60 /30Days |
Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MI cover Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MI cover Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SERTRALINE 20 MG/ML ORAL CONC ![Compare how all Medicare Part D PDP plans in MI cover SERTRALINE 20 MG/ML ORAL CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
SERTRALINE HCL 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SERTRALINE HCL 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | 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 |
$1.00 | N/A | None |
Sertraline hcl 50 mg tablet ![Compare how all Medicare Part D PDP plans in MI cover Sertraline hcl 50 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
5 |
Specialty Tier |
33% | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | 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) |
5 |
Specialty Tier |
33% | 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) |
2 |
Generic |
$7.00 | N/A | P |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
3 |
Preferred Brand |
$37.00 | N/A | None |
SIMPONI 100 MG/ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in MI cover SIMPONI 100 MG/ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SIMPONI 100 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover SIMPONI 100 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SIMPONI 50 MG/0.5 ML PEN INJEC ![Compare how all Medicare Part D PDP plans in MI cover SIMPONI 50 MG/0.5 ML PEN INJEC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIMPONI ARIA 50 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover SIMPONI ARIA 50 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR ![Compare how all Medicare Part D PDP plans in MI cover SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SIMULECT 20MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SIMULECT 20MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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 |
$1.00 | N/A | None |
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 |
$1.00 | N/A | None |
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 |
$1.00 | N/A | None |
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 |
$1.00 | N/A | None |
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 |
$1.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SIRTURO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SIRTURO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SIVEXTRO 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SIVEXTRO 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:6 /30Days |
SKLICE 0.5% LOTION ![Compare how all Medicare Part D PDP plans in MI cover SKLICE 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:117 /14Days |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | 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 |
Generic |
$7.00 | N/A | None |
SOLARAZE 3% GEL ![Compare how all Medicare Part D PDP plans in MI cover SOLARAZE 3% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOLIQUA 100 UNIT-33 MCG/ML PEN ![Compare how all Medicare Part D PDP plans in MI cover SOLIQUA 100 UNIT-33 MCG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
Solodyn 105mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Solodyn 105mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Solodyn 55mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Solodyn 55mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
Solodyn 80mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Solodyn 80mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOLODYN ER 115 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SOLODYN ER 115 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOLODYN ER 65 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SOLODYN ER 65 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
SOMATULINE DEPOT 120 MG/0.5 ML ![Compare how all Medicare Part D PDP plans in MI cover SOMATULINE DEPOT 120 MG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOMATULINE DEPOT 60 MG/0.2 ML ![Compare how all Medicare Part D PDP plans in MI cover SOMATULINE DEPOT 60 MG/0.2 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOMATULINE DEPOT 90 MG/0.3 ML ![Compare how all Medicare Part D PDP plans in MI cover SOMATULINE DEPOT 90 MG/0.3 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SOMAVERT 25 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SOMAVERT 25 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOMAVERT 30 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SOMAVERT 30 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SOOLANTRA 1% CREAM ![Compare how all Medicare Part D PDP plans in MI cover SOOLANTRA 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | None |
SORIATANE 10MG CAPSULES ![Compare how all Medicare Part D PDP plans in MI cover SORIATANE 10MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SORIATANE 17.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover SORIATANE 17.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
SORIATANE 25MG CAPSULES ![Compare how all Medicare Part D PDP plans in MI cover SORIATANE 25MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
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) |
3 |
Preferred Brand |
$37.00 | N/A | None |
SPIRIVA RESPIMAT 1.25 MCG INH ![Compare how all Medicare Part D PDP plans in MI cover SPIRIVA RESPIMAT 1.25 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | Q:8 /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) |
3 |
Preferred Brand |
$37.00 | N/A | Q:8 /30Days |
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) |
2 |
Generic |
$7.00 | N/A | 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 |
$1.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SPRINTEC 0.25-0.035 TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRINTEC 0.25-0.035 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | None |
SPRITAM 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRITAM 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:90 /30Days |
SPRITAM 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRITAM 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
SPRITAM 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRITAM 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:90 /30Days |
SPRITAM 750 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SPRITAM 750 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:90 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SRONYX 0.10-0.02 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover SRONYX 0.10-0.02 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
STELARA 130 MG/26 ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover STELARA 130 MG/26 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
STELARA 45 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover STELARA 45 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
STELARA 90 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover STELARA 90 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Sterile Water 6mg/mL 1 INJECTION, SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MI cover Sterile Water 6mg/mL 1 INJECTION, SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
STIOLTO RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in MI cover STIOLTO RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:4 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | P Q:84 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
STRENSIQ 40 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover STRENSIQ 40 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
STRENSIQ 80 MG/0.8 ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover STRENSIQ 80 MG/0.8 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
2 |
Generic |
$7.00 | N/A | None |
STRIANT 30 MG MUCOADHESIVE ![Compare how all Medicare Part D PDP plans in MI cover STRIANT 30 MG MUCOADHESIVE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
5 |
Specialty Tier |
33% | N/A | None |
STRIVERDI RESPIMAT INHAL SPRAY ![Compare how all Medicare Part D PDP plans in MI cover STRIVERDI RESPIMAT INHAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | Q:4 /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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:60 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:90 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:90 /30Days |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | P Q:90 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | P Q:56 /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) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /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) |
5 |
Specialty Tier |
33% | N/A | P Q:84 /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) |
5 |
Specialty Tier |
33% | N/A | P Q:42 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SUCRAID 8500[iU]/mL ![Compare how all Medicare Part D PDP plans in MI cover SUCRAID 8500[iU]/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
SULF-PRED 10-0.23% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover SULF-PRED 10-0.23% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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 |
$1.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
SULFAMETHOXAZOLE-TMP SS TABLET ![Compare how all Medicare Part D PDP plans in MI cover SULFAMETHOXAZOLE-TMP SS TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
SULFAMYLON CREAM 85GM 4 OZ TUBE ![Compare how all Medicare Part D PDP plans in MI cover SULFAMYLON CREAM 85GM 4 OZ TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
SULFASALAZINE DR 500 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover SULFASALAZINE DR 500 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | 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) |
2 |
Generic |
$7.00 | N/A | None |
Sumatriptan 20 MG/ACTUAT Nasal Spray ![Compare how all Medicare Part D PDP plans in MI cover Sumatriptan 20 MG/ACTUAT Nasal Spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | None |
SUMATRIPTAN 4 MG/0.5 ML CART ![Compare how all Medicare Part D PDP plans in MI cover SUMATRIPTAN 4 MG/0.5 ML CART.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | Q:4 /30Days |
Sumatriptan 5 MG/ACTUAT Nasal Spray ![Compare how all Medicare Part D PDP plans in MI cover Sumatriptan 5 MG/ACTUAT Nasal Spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | None |
SUMATRIPTAN 6 MG/0.5 ML INJECT ![Compare how all Medicare Part D PDP plans in MI cover SUMATRIPTAN 6 MG/0.5 ML INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | Q:4 /30Days |
SUMATRIPTAN 6 MG/0.5 ML REFILL ![Compare how all Medicare Part D PDP plans in MI cover SUMATRIPTAN 6 MG/0.5 ML REFILL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | Q:4 /30Days |
SUMATRIPTAN 6 MG/0.5 ML SYRNG ![Compare how all Medicare Part D PDP plans in MI cover SUMATRIPTAN 6 MG/0.5 ML SYRNG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$7.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
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) |
2 |
Generic |
$7.00 | N/A | None |
SUMAVEL DOSEPRO 4 MG/0.5 ML ![Compare how all Medicare Part D PDP plans in MI cover SUMAVEL DOSEPRO 4 MG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | S |
SUMAVEL DOSEPRO 6 MG/0.5 ML ![Compare how all Medicare Part D PDP plans in MI cover SUMAVEL DOSEPRO 6 MG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | S |
SUPRAX 100 MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in MI cover SUPRAX 100 MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | None |
SUPRAX 200 MG TABLET CHEWABLE ![Compare how all Medicare Part D PDP plans in MI cover SUPRAX 200 MG TABLET CHEWABLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | None |
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 |
Preferred Brand |
$37.00 | N/A | None |
SUPRAX 500 MG/5 ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MI cover SUPRAX 500 MG/5 ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | None |
SUPREP bowel prep 1.6; 3.13; 17.5g/mL; g/mL; g/mL 2 BOTTLE, PLASTIC per CARTON / 177.4 mL in 1 BOT ![Compare how all Medicare Part D PDP plans in MI cover SUPREP bowel prep 1.6; 3.13; 17.5g/mL; g/mL; g/mL 2 BOTTLE, PLASTIC per CARTON / 177.4 mL in 1 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Preferred Brand |
$37.00 | N/A | None |
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 |
Preferred Brand |
$37.00 | N/A | None |
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 |
Preferred Brand |
$37.00 | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
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) |
5 |
Specialty Tier |
33% | N/A | P |
SYLATRON 200 MCG KIT ![Compare how all Medicare Part D PDP plans in MI cover SYLATRON 200 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SYLATRON 300 MCG KIT ![Compare how all Medicare Part D PDP plans in MI cover SYLATRON 300 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SYLATRON 600 MCG KIT ![Compare how all Medicare Part D PDP plans in MI cover SYLATRON 600 MCG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
SYLVANT 100 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover SYLVANT 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Generic |
$7.00 | N/A | None |
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 |
Generic |
$7.00 | N/A | None |
SYMLINPEN 120 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in MI cover SYMLINPEN 120 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | S |
SYMLINPEN 60 PEN INJECTOR ![Compare how all Medicare Part D PDP plans in MI cover SYMLINPEN 60 PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$37.00 | N/A | S Q:12 /30Days |
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) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | N/A | None |
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) |
5 |
Specialty Tier |
33% | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
4 |
Non-Preferred Drug |
$80.00 | N/A | 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) |
3 |
Preferred Brand |
$37.00 | N/A | None |