2017 Medicare Part D Plan Formulary Information |
Aetna Medicare Rx Saver (PDP) (S5810-035-0)
Benefit Details
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The Aetna Medicare Rx Saver (PDP) (S5810-035-0) Formulary Drugs Starting with the Letter M in CMS PDP Region 01 which includes: ME NH Plan Monthly Premium: $34.10 Deductible: $395 Qualifies for LIS: Yes |
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 NH cover M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Magnesium sulfate 50% vial ![Compare how all Medicare Part D PDP plans in NH cover Magnesium sulfate 50% vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MAGNESIUM SULFATE INJECTION 5 GM/10ML ![Compare how all Medicare Part D PDP plans in NH cover MAGNESIUM SULFATE INJECTION 5 GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MALATHION 0.5% LOTION ![Compare how all Medicare Part D PDP plans in NH cover MALATHION 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MAPROTILINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MAPROTILINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MAPROTILINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MAPROTILINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MAPROTILINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MAPROTILINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MARLISSA-28 TABLET ![Compare how all Medicare Part D PDP plans in NH cover MARLISSA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MARPLAN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MATULANE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MATULANE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Matzim LA 180mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Matzim LA 180mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Matzim LA 240mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Matzim LA 240mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Matzim LA 300mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Matzim LA 300mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Matzim LA 360mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Matzim LA 360mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Matzim LA 420mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Matzim LA 420mg/1 90 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MECLIZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MECLIZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MECLIZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MECLIZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MECLOFENAMATE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MECLOFENAMATE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MECLOFENAMATE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MECLOFENAMATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MEDROXYPROGESTERONE 150 MG/ML ![Compare how all Medicare Part D PDP plans in NH cover MEDROXYPROGESTERONE 150 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Medroxyprogesterone Acetate 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Medroxyprogesterone Acetate 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Medroxyprogesterone Acetate 2.5mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Medroxyprogesterone Acetate 2.5mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Medroxyprogesterone Acetate 5mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Medroxyprogesterone Acetate 5mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MEFLOQUINE HCL 250MG TABLET 25 BOT ![Compare how all Medicare Part D PDP plans in NH cover MEFLOQUINE HCL 250MG TABLET 25 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MEGESTROL 20MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MEGESTROL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
MEGESTROL ACETATE 40MG TABLET (250 CT) ![Compare how all Medicare Part D PDP plans in NH cover MEGESTROL ACETATE 40MG TABLET (250 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
Megestrol Acetate 40mg/mL 480 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Megestrol Acetate 40mg/mL 480 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
MEKINIST 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MEKINIST 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
MEKINIST 2 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MEKINIST 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
Meloxicam 15 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Meloxicam 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
Meloxicam 7.5 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Meloxicam 7.5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
MELPHALAN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover MELPHALAN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEMANTINE 5-10 MG TITRATION PK [Namenda Titration] ![Compare how all Medicare Part D PDP plans in NH cover MEMANTINE 5-10 MG TITRATION PK [Namenda Titration].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P Q:98 /365Days |
MEMANTINE HCL 10 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in NH cover MEMANTINE HCL 10 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P Q:60 /30Days |
MEMANTINE HCL 2 MG/ML SOLUTION [Namenda] ![Compare how all Medicare Part D PDP plans in NH cover MEMANTINE HCL 2 MG/ML SOLUTION [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | P Q:360 /30Days |
MEMANTINE HCL 5 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in NH cover MEMANTINE HCL 5 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P Q:60 /30Days |
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 NH cover Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MENEST 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MENEST 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
MENEST 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MENEST 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
MENEST 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MENEST 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P |
MENHIBRIX VACCINE VIAL ![Compare how all Medicare Part D PDP plans in NH cover MENHIBRIX VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MENVEO A-C-Y-W-135-DIP VIAL ![Compare how all Medicare Part D PDP plans in NH cover MENVEO A-C-Y-W-135-DIP VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MERCAPTOPURINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MERCAPTOPURINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEROPENEM 500MG/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in NH cover MEROPENEM 500MG/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Mesalamine 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in NH cover Mesalamine 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MESALAMINE 800 MG DR TABLET ![Compare how all Medicare Part D PDP plans in NH cover MESALAMINE 800 MG DR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Mesna 100 mg/ml vial ![Compare how all Medicare Part D PDP plans in NH cover Mesna 100 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MESNEX 400MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MESNEX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MESTINON 60MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in NH cover MESTINON 60MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Metadate er 20 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Metadate er 20 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | P Q:90 /30Days |
METAPROTERENOL 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METAPROTERENOL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METAPROTERENOL 20MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METAPROTERENOL 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Metaproterenol Sulfate 10mg/5mL 473 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Metaproterenol Sulfate 10mg/5mL 473 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METFORMIN ER 1,000 MG OSM-TAB ![Compare how all Medicare Part D PDP plans in NH cover METFORMIN ER 1,000 MG OSM-TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METFORMIN HCL 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METFORMIN HCL 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
Metformin hcl 500 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Metformin hcl 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
METFORMIN HCL ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METFORMIN HCL ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Metformin HCL ER tab 500mg ![Compare how all Medicare Part D PDP plans in NH cover Metformin HCL ER tab 500mg.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Metformin Hydrochloride 750mg/1 ![Compare how all Medicare Part D PDP plans in NH cover Metformin Hydrochloride 750mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
METHADONE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover METHADONE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:180 /30Days |
METHADONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover METHADONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:180 /30Days |
Methadone Hydrochloride 10mg/5mL ![Compare how all Medicare Part D PDP plans in NH cover Methadone Hydrochloride 10mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:3000 /30Days |
Methadone Hydrochloride 5mg/5mL ![Compare how all Medicare Part D PDP plans in NH cover Methadone Hydrochloride 5mg/5mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:3000 /30Days |
METHADONE HYDROCHLORIDE INJECTION 10MG/ML ![Compare how all Medicare Part D PDP plans in NH cover METHADONE HYDROCHLORIDE INJECTION 10MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHAZOLAMIDE 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHAZOLAMIDE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METHAZOLAMIDE 50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHAZOLAMIDE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Methenamine Hippurate 1g/1 ![Compare how all Medicare Part D PDP plans in NH cover Methenamine Hippurate 1g/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METHIMAZOLE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHIMAZOLE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METHIMAZOLE 5MG TABLETS ![Compare how all Medicare Part D PDP plans in NH cover METHIMAZOLE 5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
methotrexate 1 gm vial ![Compare how all Medicare Part D PDP plans in NH cover methotrexate 1 gm vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METHOTREXATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHOTREXATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Methotrexate 25 mg/ml vial ![Compare how all Medicare Part D PDP plans in NH cover Methotrexate 25 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Methotrexate 50 mg/2 ml vial ![Compare how all Medicare Part D PDP plans in NH cover Methotrexate 50 mg/2 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Methoxsalen 10 mg Capsule [8-MOP] ![Compare how all Medicare Part D PDP plans in NH cover Methoxsalen 10 mg Capsule [8-MOP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METHSCOPOLAMINE BROMIDE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHSCOPOLAMINE BROMIDE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHSCOPOLAMINE BROMIDE 5 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover METHSCOPOLAMINE BROMIDE 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METHYCLOTHIAZIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHYCLOTHIAZIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METHYLPHENIDATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHYLPHENIDATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
METHYLPHENIDATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHYLPHENIDATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
Methylphenidate er 20 mg cap ![Compare how all Medicare Part D PDP plans in NH cover Methylphenidate er 20 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P Q:30 /30Days |
Methylphenidate er 40 mg cap ![Compare how all Medicare Part D PDP plans in NH cover Methylphenidate er 40 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P Q:30 /30Days |
METHYLPHENIDATE HYDROCHLORIDE 5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover METHYLPHENIDATE HYDROCHLORIDE 5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | P Q:90 /30Days |
METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | P Q:90 /30Days |
Methylphenidate la 60 mg cap ![Compare how all Medicare Part D PDP plans in NH cover Methylphenidate la 60 mg cap.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | P Q:30 /30Days |
Methylprednisolone 125 mg vial ![Compare how all Medicare Part D PDP plans in NH cover Methylprednisolone 125 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPREDNISOLONE 16MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHYLPREDNISOLONE 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METHYLPREDNISOLONE 32MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHYLPREDNISOLONE 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METHYLPREDNISOLONE 4 MG DOSEPK ![Compare how all Medicare Part D PDP plans in NH cover METHYLPREDNISOLONE 4 MG DOSEPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
methylprednisolone 40 mg vial ![Compare how all Medicare Part D PDP plans in NH cover methylprednisolone 40 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Methylprednisolone 40 mg/ml vl ![Compare how all Medicare Part D PDP plans in NH cover Methylprednisolone 40 mg/ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Methylprednisolone 4mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Methylprednisolone 4mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METHYLPREDNISOLONE 8 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in NH cover METHYLPREDNISOLONE 8 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Methylprednisolone 80 mg/ml vl ![Compare how all Medicare Part D PDP plans in NH cover Methylprednisolone 80 mg/ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Metipranolol 0.3% eye drops ![Compare how all Medicare Part D PDP plans in NH cover Metipranolol 0.3% eye drops.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
Metoclopramide 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Metoclopramide 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Metoclopramide 5 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Metoclopramide 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOCLOPRAMIDE 5 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in NH cover METOCLOPRAMIDE 5 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Metoclopramide 5mg/mL 25 VIAL in 1 TRAY / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in NH 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) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
METOLAZONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METOLAZONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
METOLAZONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METOLAZONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
METOLAZONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METOLAZONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
METOPROLOL SUCC ER 100 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL SUCC ER 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METOPROLOL SUCC ER 50 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL SUCC ER 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METOPROLOL SUCCINATE ER 200 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL SUCCINATE ER 200 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METOPROLOL SUCCINATE ER 25 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL SUCCINATE ER 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METOPROLOL TARTRATE 100 MG TAB ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL TARTRATE 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
Metoprolol Tartrate 1mg/mL 3 AMPULE in 1 CARTON / 5 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in NH 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 |
$1.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL TARTRATE 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL TARTRATE 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
METOPROLOL TARTRATE INJ.USP 5MG/5ML CARPUJECT ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL TARTRATE INJ.USP 5MG/5ML CARPUJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
METRONIDAZOLE 0.75% CREAM ![Compare how all Medicare Part D PDP plans in NH cover METRONIDAZOLE 0.75% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METRONIDAZOLE 0.75% LOTION ![Compare how all Medicare Part D PDP plans in NH cover METRONIDAZOLE 0.75% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
metronidazole 375 mg capsule ![Compare how all Medicare Part D PDP plans in NH cover metronidazole 375 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Metronidazole 500mg/100mL 24 BAG per CARTON / 100 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in NH cover Metronidazole 500mg/100mL 24 BAG per CARTON / 100 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METRONIDAZOLE TABLETS USP 250MG 250 BOTPL ![Compare how all Medicare Part D PDP plans in NH cover METRONIDAZOLE TABLETS USP 250MG 250 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METRONIDAZOLE TABLETS USP 500MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in NH cover METRONIDAZOLE TABLETS USP 500MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
metronidazole topical 1% gel ![Compare how all Medicare Part D PDP plans in NH cover metronidazole topical 1% gel.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover METRONIDAZOLE TOPICAL GEL 0.75% 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
METRONIDAZOLE VAGINAL GEL ![Compare how all Medicare Part D PDP plans in NH cover METRONIDAZOLE VAGINAL GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MEXILETINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MEXILETINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MEXILETINE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MEXILETINE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MEXILETINE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MEXILETINE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MIACALCIN 400 UNIT/2 ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover MIACALCIN 400 UNIT/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MIBELAS 24 Fe chewable tablet ![Compare how all Medicare Part D PDP plans in NH cover MIBELAS 24 Fe chewable tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Microgestin 21 1-20 tablet ![Compare how all Medicare Part D PDP plans in NH cover Microgestin 21 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MICROGESTIN 21 1.5-30 TAB ![Compare how all Medicare Part D PDP plans in NH cover MICROGESTIN 21 1.5-30 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Microgestin fe 1-20 tablet ![Compare how all Medicare Part D PDP plans in NH cover Microgestin fe 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MICROGESTIN FE 1.5-30 TAB ![Compare how all Medicare Part D PDP plans in NH cover MICROGESTIN FE 1.5-30 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MIDODRINE HCL 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MIDODRINE HCL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MIDODRINE HCL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MIDODRINE HCL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MIDODRINE HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover MIDODRINE HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Migergot suppository ![Compare how all Medicare Part D PDP plans in NH cover Migergot suppository.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:20 /28Days |
MILLIPRED 10 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover MILLIPRED 10 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Millipred 5 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Millipred 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
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 NH 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) |
2* |
Generic |
$2.00 | $6.00 | P |
Mimvey lo 0.5-0.1 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Mimvey lo 0.5-0.1 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | P |
MINITRAN 0.1 MG/HR PATCH ![Compare how all Medicare Part D PDP plans in NH cover MINITRAN 0.1 MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MINITRAN 0.2 MG/HR PATCH ![Compare how all Medicare Part D PDP plans in NH cover MINITRAN 0.2 MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MINITRAN 0.4 MG/HR PATCH ![Compare how all Medicare Part D PDP plans in NH cover MINITRAN 0.4 MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MINITRAN 0.6 MG/HR PATCH ![Compare how all Medicare Part D PDP plans in NH cover MINITRAN 0.6 MG/HR PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MINOCYCLINE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MINOCYCLINE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MINOCYCLINE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MINOCYCLINE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Minocycline Hydrochloride 100mg/1 50 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NH cover Minocycline Hydrochloride 100mg/1 50 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MINOXIDIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MINOXIDIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MINOXIDIL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MINOXIDIL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Mirtazapine 15 mg odt ![Compare how all Medicare Part D PDP plans in NH cover Mirtazapine 15 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days |
Mirtazapine 15mg/1 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Mirtazapine 15mg/1 1000 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MIRTAZAPINE 30 MG ODT ![Compare how all Medicare Part D PDP plans in NH cover MIRTAZAPINE 30 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Mirtazapine 45 mg odt ![Compare how all Medicare Part D PDP plans in NH cover Mirtazapine 45 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days |
Mirtazapine 45mg/1 500 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Mirtazapine 45mg/1 500 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
Mirtazapine 7.5mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Mirtazapine 7.5mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MIRTAZAPINE TABLET 30MG (30 CT) ![Compare how all Medicare Part D PDP plans in NH cover MIRTAZAPINE TABLET 30MG (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
misoprostol 100 mcg tablet ![Compare how all Medicare Part D PDP plans in NH cover misoprostol 100 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
misoprostol 200 mcg tablet ![Compare how all Medicare Part D PDP plans in NH cover misoprostol 200 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MITIGARE 0.6 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MITIGARE 0.6 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MITOMYCIN 20 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover MITOMYCIN 20 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MITOMYCIN 40 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover MITOMYCIN 40 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
MITOMYCIN 5 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover MITOMYCIN 5 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MITOXANTRONE INJECTION 2MG 125ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover MITOXANTRONE INJECTION 2MG 125ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Modafinil 100 mg tablet [Provigil] ![Compare how all Medicare Part D PDP plans in NH cover Modafinil 100 mg tablet [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P Q:30 /30Days |
Modafinil 200 mg tablet [Provigil] ![Compare how all Medicare Part D PDP plans in NH cover Modafinil 200 mg tablet [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P Q:60 /30Days |
Moderiba 200 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Moderiba 200 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Moexipril hcl 15 mg tablet ![Compare how all Medicare Part D PDP plans in NH cover Moexipril hcl 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
Moexipril HCL 7.5mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NH 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 |
$1.00 | $3.00 | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 15-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MOEXIPRIL-HYDROCHLOROTHIAZIDE 7.5-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | None |
MOMETASONE FUROATE 0.1% CREAM ![Compare how all Medicare Part D PDP plans in NH cover MOMETASONE FUROATE 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MOMETASONE FUROATE 0.1% OINT ![Compare how all Medicare Part D PDP plans in NH cover MOMETASONE FUROATE 0.1% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MOMETASONE FUROATE 0.1% SOLN ![Compare how all Medicare Part D PDP plans in NH cover MOMETASONE FUROATE 0.1% SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOMETASONE FUROATE 50 MCG SPRY ![Compare how all Medicare Part D PDP plans in NH cover MOMETASONE FUROATE 50 MCG SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:34 /30Days |
MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN ![Compare how all Medicare Part D PDP plans in NH cover MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MONTELUKAST SOD 10 MG TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in NH cover MONTELUKAST SOD 10 MG TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | Q:30 /30Days |
montelukast sod 4 mg granules [Singulair] ![Compare how all Medicare Part D PDP plans in NH cover montelukast sod 4 mg granules [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days |
Montelukast sod 4 mg tab chew [Singulair] ![Compare how all Medicare Part D PDP plans in NH cover Montelukast sod 4 mg tab chew [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | Q:30 /30Days |
Montelukast sod 5 mg tab chew [Singulair] ![Compare how all Medicare Part D PDP plans in NH cover Montelukast sod 5 mg tab chew [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$1.00 | $3.00 | Q:30 /30Days |
MORGIDOX 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MORGIDOX 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
MORPHINE 10 MG/ML ISECURE SYR ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE 10 MG/ML ISECURE SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
Morphine 2 mg/ml isecure syr ![Compare how all Medicare Part D PDP plans in NH cover Morphine 2 mg/ml isecure syr.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
Morphine 4 mg/ml isecure syr ![Compare how all Medicare Part D PDP plans in NH cover Morphine 4 mg/ml isecure syr.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
MORPHINE 8 MG/ML ISECURE SYR ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE 8 MG/ML ISECURE SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE 10 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 10 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:1800 /30Days |
MORPHINE SULFATE 100 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 100 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:180 /30Days |
MORPHINE SULFATE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE 15MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 15MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:90 /30Days |
MORPHINE SULFATE 15MG TABLETS ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 15MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | Q:60 /30Days |
MORPHINE SULFATE 20 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 20 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:1020 /30Days |
MORPHINE SULFATE 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE 30MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 30MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE 30MG TABLETS ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE 30MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | Q:180 /30Days |
MORPHINE SULFATE ER 10 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 10 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE ER 100 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE ER 120 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 120 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
MORPHINE SULFATE ER 20 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 20 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE ER 30 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 30 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MORPHINE SULFATE ER 30 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 30 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MORPHINE SULFATE ER 45 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 45 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
MORPHINE SULFATE ER 50 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 50 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MORPHINE SULFATE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MORPHINE SULFATE ER 75 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 75 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
MORPHINE SULFATE ER 80 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 80 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MORPHINE SULFATE ER 90 MG CAP ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE ER 90 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE TABLET ER 60MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover MORPHINE SULFATE TABLET ER 60MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | Q:60 /30Days |
MOVIPREP 7.5-2.691G POWDER IN PACKET ![Compare how all Medicare Part D PDP plans in NH cover MOVIPREP 7.5-2.691G POWDER IN PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MOXEZA 5.45mg/mL 3 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover MOXEZA 5.45mg/mL 3 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MOZOBIL 20 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover MOZOBIL 20 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NH cover Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | None |
mupirocin 2% cream ![Compare how all Medicare Part D PDP plans in NH cover mupirocin 2% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MUPIROCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover MUPIROCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$2.00 | $6.00 | None |
MUSTARGEN 10 MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover MUSTARGEN 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MYCOPHENOLATE 200 MG/ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover MYCOPHENOLATE 200 MG/ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Mycophenolate 500 mg vial ![Compare how all Medicare Part D PDP plans in NH cover Mycophenolate 500 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | 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 NH cover Mycophenolate Mofetil 250mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | 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 NH cover MYCOPHENOLATE MOFETIL TABLETS 500MG 500 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | P |
MYORISAN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MYORISAN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MYORISAN 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MYORISAN 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
Myorisan 30 mg capsule ![Compare how all Medicare Part D PDP plans in NH cover Myorisan 30 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MYORISAN 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover MYORISAN 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
35% | 35% | None |
MYRBETRIQ ER 25 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MYRBETRIQ ER 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days |
MYRBETRIQ ER 50 MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover MYRBETRIQ ER 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days |