2017 Medicare Part D Plan Formulary Information |
UPMC for Life PPO High Deductible with Rx (PPO) (H5533-003-0)
Benefit Details
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The UPMC for Life PPO High Deductible with Rx (PPO) (H5533-003-0) Formulary Drugs Starting with the Letter M in Crawford County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $37.00 Deductible: $0 |
Drugs Starting with Letter M
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML ![Compare how all Medicare Part D PDP plans in PA cover M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
Magnesium sulfate 50% vial ![Compare how all Medicare Part D PDP plans in PA cover Magnesium sulfate 50% vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MAGNESIUM SULFATE INJECTION 5 GM/10ML ![Compare how all Medicare Part D PDP plans in PA cover MAGNESIUM SULFATE INJECTION 5 GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MAKENA 250 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MAKENA 250 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
MALATHION 0.5% LOTION ![Compare how all Medicare Part D PDP plans in PA cover MALATHION 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MAPROTILINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MAPROTILINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MAPROTILINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MARLISSA-28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover MARLISSA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MARPLAN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MATULANE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MATULANE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Matzim LA 180mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Matzim LA 180mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Matzim LA 240mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Matzim LA 240mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Matzim LA 300mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Matzim LA 300mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Matzim LA 360mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Matzim LA 360mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Matzim LA 420mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Matzim LA 420mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MAXIDEX OPHTHALMIC SUSPENSION 0.1% 5ML BOT ![Compare how all Medicare Part D PDP plans in PA cover MAXIDEX OPHTHALMIC SUSPENSION 0.1% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MECLIZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MECLIZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MECLIZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MECLIZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MECLOFENAMATE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MECLOFENAMATE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MECLOFENAMATE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MECLOFENAMATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEDROXYPROGESTERONE 150 MG/ML ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 150 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Medroxyprogesterone Acetate 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Medroxyprogesterone Acetate 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Medroxyprogesterone Acetate 2.5mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Medroxyprogesterone Acetate 2.5mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Medroxyprogesterone Acetate 5mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Medroxyprogesterone Acetate 5mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MEFLOQUINE HCL 250MG TABLET 25 BOT ![Compare how all Medicare Part D PDP plans in PA cover MEFLOQUINE HCL 250MG TABLET 25 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MEGESTROL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
MEGESTROL ACETATE 40MG TABLET (250 CT) ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL ACETATE 40MG TABLET (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Megestrol Acetate 40mg/mL 480 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Megestrol Acetate 40mg/mL 480 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
MEKINIST 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEKINIST 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
MEKINIST 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEKINIST 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Meloxicam 15 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Meloxicam 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Meloxicam 7.5 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Meloxicam 7.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MELPHALAN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover MELPHALAN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MEMANTINE 5-10 MG TITRATION PK [Namenda Titration] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE 5-10 MG TITRATION PK [Namenda Titration].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | P |
MEMANTINE HCL 10 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE HCL 10 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
MEMANTINE HCL 2 MG/ML SOLUTION [Namenda] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE HCL 2 MG/ML SOLUTION [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
MEMANTINE HCL 5 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE HCL 5 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL ![Compare how all Medicare Part D PDP plans in PA cover Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MENEST 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MENEST 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MENEST 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MENEST 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MENEST 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MENEST 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MENHIBRIX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in PA cover MENHIBRIX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MENOSTAR 14 MCG/DAY PATCH ![Compare how all Medicare Part D PDP plans in PA cover MENOSTAR 14 MCG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MENVEO A-C-Y-W-135-DIP VIAL ![Compare how all Medicare Part D PDP plans in PA cover MENVEO A-C-Y-W-135-DIP VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MERCAPTOPURINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MERCAPTOPURINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MEROPENEM 500MG/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover MEROPENEM 500MG/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
Mesalamine 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in PA cover Mesalamine 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Mesna 100 mg/ml vial ![Compare how all Medicare Part D PDP plans in PA cover Mesna 100 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
MESNEX 400MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MESNEX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MESTINON 60MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in PA cover MESTINON 60MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Metadate er 20 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Metadate er 20 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:90 /30Days |
METAPROTERENOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METAPROTERENOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METAPROTERENOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METAPROTERENOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Metaproterenol Sulfate 10mg/5mL 473 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Metaproterenol Sulfate 10mg/5mL 473 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METFORMIN HCL 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | Q:75 /30Days |
Metformin hcl 500 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Metformin hcl 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | Q:150 /30Days |
METFORMIN HCL ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | Q:120 /30Days |
Metformin Hydrochloride 750mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Metformin Hydrochloride 750mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | Q:60 /30Days |
METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | Q:90 /30Days |
METHADONE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHADONE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:90 /30Days |
METHADONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover METHADONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:200 /30Days |
Methadone Hydrochloride 10mg/5mL ![Compare how all Medicare Part D PDP plans in PA cover Methadone Hydrochloride 10mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | Q:1000 /30Days |
Methadone Hydrochloride 5mg/5mL ![Compare how all Medicare Part D PDP plans in PA cover Methadone Hydrochloride 5mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:2000 /30Days |
METHADONE HYDROCHLORIDE INJECTION 10MG/ML ![Compare how all Medicare Part D PDP plans in PA cover METHADONE HYDROCHLORIDE INJECTION 10MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:160 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHAMPHETAMINE HYDROCHLORIDE TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in PA cover METHAMPHETAMINE HYDROCHLORIDE TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:150 /30Days |
METHAZOLAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHAZOLAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
METHAZOLAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHAZOLAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Methenamine Hippurate 1g/1 ![Compare how all Medicare Part D PDP plans in PA cover Methenamine Hippurate 1g/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHIMAZOLE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHIMAZOLE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHIMAZOLE 5MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover METHIMAZOLE 5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Methocarbamol 500mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Methocarbamol 500mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
METHOCARBAMOL 750MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover METHOCARBAMOL 750MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Methotrexate 0.55 ML 50 MG/ML Auto-Injector [Rasuvo] ![Compare how all Medicare Part D PDP plans in PA cover Methotrexate 0.55 ML 50 MG/ML Auto-Injector [Rasuvo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | P Q:2 /28Days |
methotrexate 1 gm vial ![Compare how all Medicare Part D PDP plans in PA cover methotrexate 1 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
METHOTREXATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHOTREXATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Methotrexate 25 mg/ml vial ![Compare how all Medicare Part D PDP plans in PA cover Methotrexate 25 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Methotrexate 50 mg/2 ml vial ![Compare how all Medicare Part D PDP plans in PA cover Methotrexate 50 mg/2 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Methoxsalen 10 mg Capsule [8-MOP] ![Compare how all Medicare Part D PDP plans in PA cover Methoxsalen 10 mg Capsule [8-MOP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
METHSCOPOLAMINE BROMIDE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHSCOPOLAMINE BROMIDE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
METHSCOPOLAMINE BROMIDE 5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METHSCOPOLAMINE BROMIDE 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
METHYCLOTHIAZIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYCLOTHIAZIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHYLPHENIDATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P Q:90 /30Days |
METHYLPHENIDATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P Q:150 /30Days |
METHYLPHENIDATE CD 10 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 10 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
METHYLPHENIDATE CD 30 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 30 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
methylphenidate cd 50 mg cap ![Compare how all Medicare Part D PDP plans in PA cover methylphenidate cd 50 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
methylphenidate cd 60 mg cap ![Compare how all Medicare Part D PDP plans in PA cover methylphenidate cd 60 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
METHYLPHENIDATE ER 18 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE ER 18 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
Methylphenidate er 20 mg cap ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate er 20 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
Methylphenidate er 20 mg cap ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate er 20 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
METHYLPHENIDATE ER 27 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE ER 27 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
METHYLPHENIDATE ER 36 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE ER 36 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:60 /30Days |
Methylphenidate er 40 mg cap ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate er 40 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
Methylphenidate er 40 mg cap ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate er 40 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
METHYLPHENIDATE ER 54 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE ER 54 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
Methylphenidate Hydrochloride 10mg/5mL 500 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate Hydrochloride 10mg/5mL 500 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:900 /30Days |
METHYLPHENIDATE HYDROCHLORIDE 5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE HYDROCHLORIDE 5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Methylphenidate Hydrochloride 5mg/5mL 500 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate Hydrochloride 5mg/5mL 500 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:1800 /30Days |
METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:90 /30Days |
METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:90 /30Days |
Methylphenidate la 60 mg cap ![Compare how all Medicare Part D PDP plans in PA cover Methylphenidate la 60 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P Q:30 /30Days |
Methylprednisolone 125 mg vial ![Compare how all Medicare Part D PDP plans in PA cover Methylprednisolone 125 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHYLPREDNISOLONE 16MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHYLPREDNISOLONE 32MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHYLPREDNISOLONE 4 MG DOSEPK ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 4 MG DOSEPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
methylprednisolone 40 mg vial ![Compare how all Medicare Part D PDP plans in PA cover methylprednisolone 40 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Methylprednisolone 40 mg/ml vl ![Compare how all Medicare Part D PDP plans in PA cover Methylprednisolone 40 mg/ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Methylprednisolone 4mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Methylprednisolone 4mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPREDNISOLONE 8 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 8 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Methylprednisolone 80 mg/ml vl ![Compare how all Medicare Part D PDP plans in PA cover Methylprednisolone 80 mg/ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METHYLTESTOSTERONE 10 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover METHYLTESTOSTERONE 10 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Metipranolol 0.3% eye drops ![Compare how all Medicare Part D PDP plans in PA cover Metipranolol 0.3% eye drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Metoclopramide 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Metoclopramide 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Metoclopramide 5 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Metoclopramide 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOCLOPRAMIDE 5 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE 5 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Metoclopramide 5mg/mL 25 VIAL in 1 TRAY / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in PA cover Metoclopramide 5mg/mL 25 VIAL in 1 TRAY / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOLAZONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOLAZONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOLAZONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL SUCC ER 100 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCC ER 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL SUCC ER 50 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCC ER 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL SUCCINATE ER 200 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCCINATE ER 200 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL SUCCINATE ER 25 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCCINATE ER 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL TARTRATE 100 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Metoprolol Tartrate 1mg/mL 3 AMPULE in 1 CARTON / 5 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in PA cover Metoprolol Tartrate 1mg/mL 3 AMPULE in 1 CARTON / 5 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL TARTRATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL TARTRATE INJ.USP 5MG/5ML CARPUJECT ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE INJ.USP 5MG/5ML CARPUJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
METRONIDAZOLE 0.75% CREAM ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 0.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METRONIDAZOLE 0.75% LOTION ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 0.75% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
metronidazole 375 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover metronidazole 375 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Metronidazole 500mg/100mL 24 BAG per CARTON / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in PA cover Metronidazole 500mg/100mL 24 BAG per CARTON / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METRONIDAZOLE TABLETS USP 250MG 250 BOTPL ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TABLETS USP 250MG 250 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METRONIDAZOLE TABLETS USP 500MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TABLETS USP 500MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
METRONIDAZOLE VAGINAL GEL ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE VAGINAL GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MEXILETINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MEXILETINE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEXILETINE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MIACALCIN 400 UNIT/2 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MIACALCIN 400 UNIT/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MICONAZOLE 3 200MG SUPPOS. ![Compare how all Medicare Part D PDP plans in PA cover MICONAZOLE 3 200MG SUPPOS..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Microgestin 21 1-20 tablet ![Compare how all Medicare Part D PDP plans in PA cover Microgestin 21 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MICROGESTIN 21 1.5-30 TAB ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN 21 1.5-30 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Microgestin fe 1-20 tablet ![Compare how all Medicare Part D PDP plans in PA cover Microgestin fe 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MICROGESTIN FE 1.5-30 TAB ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN FE 1.5-30 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MIDODRINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIDODRINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MIDODRINE HCL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIDODRINE HCL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MIDODRINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MIDODRINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Migergot suppository ![Compare how all Medicare Part D PDP plans in PA cover Migergot suppository.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Mimvey 1; 0.5mg/1; mg/1 1 BLISTER PACK in 1 CARTON / 28 FILM COATED TABLETS in BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover Mimvey 1; 0.5mg/1; mg/1 1 BLISTER PACK in 1 CARTON / 28 FILM COATED TABLETS in BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Mimvey lo 0.5-0.1 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Mimvey lo 0.5-0.1 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MINOCYCLINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MINOCYCLINE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Minocycline Hydrochloride 100mg/1 50 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Minocycline Hydrochloride 100mg/1 50 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MINOXIDIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MINOXIDIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MINOXIDIL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MINOXIDIL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Mirtazapine 15 mg odt ![Compare how all Medicare Part D PDP plans in PA cover Mirtazapine 15 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Mirtazapine 15mg/1 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Mirtazapine 15mg/1 1000 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MIRTAZAPINE 30 MG ODT ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 30 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Mirtazapine 45 mg odt ![Compare how all Medicare Part D PDP plans in PA cover Mirtazapine 45 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Mirtazapine 45mg/1 500 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Mirtazapine 45mg/1 500 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Mirtazapine 7.5mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Mirtazapine 7.5mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MIRTAZAPINE TABLET 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE TABLET 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
misoprostol 100 mcg tablet ![Compare how all Medicare Part D PDP plans in PA cover misoprostol 100 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
misoprostol 200 mcg tablet ![Compare how all Medicare Part D PDP plans in PA cover misoprostol 200 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MITOMYCIN 20 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MITOMYCIN 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MITOMYCIN 40 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MITOMYCIN 40 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MITOMYCIN 5 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MITOMYCIN 5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MITOXANTRONE INJECTION 2MG 125ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MITOXANTRONE INJECTION 2MG 125ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
Modafinil 100 mg tablet [Provigil] ![Compare how all Medicare Part D PDP plans in PA cover Modafinil 100 mg tablet [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | P Q:60 /30Days |
Modafinil 200 mg tablet [Provigil] ![Compare how all Medicare Part D PDP plans in PA cover Modafinil 200 mg tablet [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Moderiba 200 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Moderiba 200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Moderiba 400-400 mg dosepack ![Compare how all Medicare Part D PDP plans in PA cover Moderiba 400-400 mg dosepack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Moderiba 600-600 mg dosepack ![Compare how all Medicare Part D PDP plans in PA cover Moderiba 600-600 mg dosepack.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Moexipril hcl 15 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Moexipril hcl 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Moexipril HCL 7.5mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Moexipril HCL 7.5mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MOMETASONE FUROATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MOMETASONE FUROATE 0.1% OINT ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE 0.1% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MOMETASONE FUROATE 0.1% SOLN ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE 0.1% SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN ![Compare how all Medicare Part D PDP plans in PA cover MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MONTELUKAST SOD 10 MG TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover MONTELUKAST SOD 10 MG TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
montelukast sod 4 mg granules [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover montelukast sod 4 mg granules [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Montelukast sod 4 mg tab chew [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover Montelukast sod 4 mg tab chew [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Montelukast sod 5 mg tab chew [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover Montelukast sod 5 mg tab chew [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MORGIDOX 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MORGIDOX 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Morphine 2 mg/ml isecure syr ![Compare how all Medicare Part D PDP plans in PA cover Morphine 2 mg/ml isecure syr.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:1000 /30Days |
Morphine 4 mg/ml isecure syr ![Compare how all Medicare Part D PDP plans in PA cover Morphine 4 mg/ml isecure syr.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:500 /30Days |
MORPHINE SULFATE 10 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 10 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:900 /30Days |
MORPHINE SULFATE 100 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 100 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:300 /30Days |
MORPHINE SULFATE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE 15MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 15MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:90 /30Days |
MORPHINE SULFATE 15MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 15MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:180 /30Days |
MORPHINE SULFATE 20 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 20 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:900 /30Days |
MORPHINE SULFATE 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:30 /30Days |
MORPHINE SULFATE 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:90 /30Days |
MORPHINE SULFATE 30MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 30MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:180 /30Days |
MORPHINE SULFATE TABLET ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE TABLET ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:90 /30Days |
MOVANTIK 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOVANTIK 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MOVANTIK 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOVANTIK 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MOXEZA 5.45mg/mL 3 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover MOXEZA 5.45mg/mL 3 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MOXIFLOXACIN 400 MG/250 ML BAG [Avelox] ![Compare how all Medicare Part D PDP plans in PA cover MOXIFLOXACIN 400 MG/250 ML BAG [Avelox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOXIFLOXACIN HCL 400 MG TABLET [Avelox] ![Compare how all Medicare Part D PDP plans in PA cover MOXIFLOXACIN HCL 400 MG TABLET [Avelox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MOZOBIL 20 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover MOZOBIL 20 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:10 /4Days |
Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MUPIROCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover MUPIROCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
MUSTARGEN 10 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MUSTARGEN 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MYALEPT 11.3 MG (5 MG/ML) VIAL ![Compare how all Medicare Part D PDP plans in PA cover MYALEPT 11.3 MG (5 MG/ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
MYCAMINE 100MG/VIAL FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover MYCAMINE 100MG/VIAL FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MYCAMINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MYCAMINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
MYCOPHENOLATE 200 MG/ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE 200 MG/ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Mycophenolate 500 mg vial ![Compare how all Medicare Part D PDP plans in PA cover Mycophenolate 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Mycophenolate Mofetil 250mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA cover Mycophenolate Mofetil 250mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Mycophenolic Acid DR 180 mg tb ![Compare how all Medicare Part D PDP plans in PA cover Mycophenolic Acid DR 180 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Mycophenolic Acid DR 360 mg tb ![Compare how all Medicare Part D PDP plans in PA cover Mycophenolic Acid DR 360 mg tb.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
MYORISAN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYORISAN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MYORISAN 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYORISAN 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Myorisan 30 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover Myorisan 30 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MYORISAN 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYORISAN 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
MYRBETRIQ ER 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MYRBETRIQ ER 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MYRBETRIQ ER 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MYRBETRIQ ER 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
MYTESI 125 MG DR TABLET ![Compare how all Medicare Part D PDP plans in PA cover MYTESI 125 MG DR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |