2018 Medicare Part D Plan Formulary Information |
AARP MedicareComplete Plan 2 (HMO) (H2802-019-0)
Benefit Details
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The AARP MedicareComplete Plan 2 (HMO) (H2802-019-0) Formulary Drugs Starting with the Letter P in Jasper County, IN: CMS MA Region 13 which includes: IN Plan Monthly Premium: $77.00 Deductible: $0 |
Drugs Starting with Letter P
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
PACERONE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PACERONE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PACLITAXEL 100 MG/16.7 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PACLITAXEL 100 MG/16.7 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PALIPERIDONE ER 1.5 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in IN cover PALIPERIDONE ER 1.5 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PALIPERIDONE ER 3 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in IN cover PALIPERIDONE ER 3 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PALIPERIDONE ER 6 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in IN cover PALIPERIDONE ER 6 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days |
PALIPERIDONE ER 9 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in IN cover PALIPERIDONE ER 9 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:30 /30Days |
PALONOSETRON 0.25 MG/2 ML VIAL [Aloxi] ![Compare how all Medicare Part D PDP plans in IN cover PALONOSETRON 0.25 MG/2 ML VIAL [Aloxi].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PALONOSETRON 0.25 MG/5 ML VIAL [Aloxi] ![Compare how all Medicare Part D PDP plans in IN cover PALONOSETRON 0.25 MG/5 ML VIAL [Aloxi].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PAMIDRONATE 30 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PAMIDRONATE 30 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PAMIDRONATE 60MG/10ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PAMIDRONATE 60MG/10ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAMIDRONATE 90 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PAMIDRONATE 90 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
PANTOPRAZOLE SOD DR 20 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PANTOPRAZOLE SOD DR 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:90 /30Days |
PANTOPRAZOLE SOD DR 40 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PANTOPRAZOLE SOD DR 40 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:60 /30Days |
PARICALCITOL 1 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in IN cover PARICALCITOL 1 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PARICALCITOL 10 MCG/2 ML VIAL [Zemplar] ![Compare how all Medicare Part D PDP plans in IN cover PARICALCITOL 10 MCG/2 ML VIAL [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PARICALCITOL 2 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in IN cover PARICALCITOL 2 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PARICALCITOL 2 MCG/ML VIAL [Zemplar] ![Compare how all Medicare Part D PDP plans in IN cover PARICALCITOL 2 MCG/ML VIAL [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PARICALCITOL 4 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in IN cover PARICALCITOL 4 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PAROMOMYCIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PAROMOMYCIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PAROXETINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE HCL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PAROXETINE HCL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PAROXETINE HCL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PAROXETINE HCL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in IN cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PAXIL ORAL SUSPENSION 10 MG/5ML ![Compare how all Medicare Part D PDP plans in IN cover PAXIL ORAL SUSPENSION 10 MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PAZEO 0.7% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover PAZEO 0.7% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in IN cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PEG 3350 ELECTROLYTE SOLN SOLN RECON [GaviLyte-C] ![Compare how all Medicare Part D PDP plans in IN cover PEG 3350 ELECTROLYTE SOLN SOLN RECON [GaviLyte-C].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PEG 3350-ELECTROLYTE SOLUTION SOLN RECON ![Compare how all Medicare Part D PDP plans in IN cover PEG 3350-ELECTROLYTE SOLUTION SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PEG-3350 AND ELECTROLYTES SOLN SOLN RECON ![Compare how all Medicare Part D PDP plans in IN cover PEG-3350 AND ELECTROLYTES SOLN SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PEGANONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PEGANONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Pegasys 180ug/0.5mL 1 PACKET in 1 BOX / 4 SYRINGE, GLASS in 1 PACKET / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in IN cover Pegasys 180ug/0.5mL 1 PACKET in 1 BOX / 4 SYRINGE, GLASS in 1 PACKET / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PEGASYS INJECTION ![Compare how all Medicare Part D PDP plans in IN cover PEGASYS INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PEGASYS PROCLICK 135 MCG/0.5 ![Compare how all Medicare Part D PDP plans in IN cover PEGASYS PROCLICK 135 MCG/0.5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PEGASYS PROCLICK 180 MCG/0.5 ![Compare how all Medicare Part D PDP plans in IN cover PEGASYS PROCLICK 180 MCG/0.5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Penicillin G Sodium 5000000[iU]/1 10 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in IN cover Penicillin G Sodium 5000000[iU]/1 10 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PENICILLIN GK 20 MILLION UNIT ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN GK 20 MILLION UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PENICILLIN VK 125 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN VK 125 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PENICILLIN VK 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PENICILLIN VK 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENTAM 300 INJ 300MG ![Compare how all Medicare Part D PDP plans in IN cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:360 /30Days |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:240 /30Days |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PERFOROMIST 20MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in IN cover PERFOROMIST 20MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P Q:120 /30Days |
PERINDOPRIL ERBUMINE 2 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PERINDOPRIL ERBUMINE 2 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:60 /30Days |
PERINDOPRIL ERBUMINE 4 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PERINDOPRIL ERBUMINE 4 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:60 /30Days |
PERINDOPRIL ERBUMINE 8 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PERINDOPRIL ERBUMINE 8 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:60 /30Days |
PERIOGARD 0.12% ORAL RINSE ![Compare how all Medicare Part D PDP plans in IN cover PERIOGARD 0.12% ORAL RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PERJETA 420 MG/14 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PERJETA 420 MG/14 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in IN cover Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Perphenazine 16mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Perphenazine 16mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PERPHENAZINE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PERPHENAZINE 8 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PERPHENAZINE TABLETS USP 2MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover PERPHENAZINE TABLETS USP 2MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PHENADOZ 12.5 MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in IN cover PHENADOZ 12.5 MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Phenobarbital 100mg/1 ![Compare how all Medicare Part D PDP plans in IN cover Phenobarbital 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Phenobarbital 15mg/1 ![Compare how all Medicare Part D PDP plans in IN cover Phenobarbital 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENOBARBITAL 16.2 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PHENOBARBITAL 16.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENOBARBITAL 20 MG/5 ML ELIX ![Compare how all Medicare Part D PDP plans in IN cover PHENOBARBITAL 20 MG/5 ML ELIX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Phenobarbital 30mg/1 ![Compare how all Medicare Part D PDP plans in IN cover Phenobarbital 30mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENOBARBITAL 32.4 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PHENOBARBITAL 32.4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Phenobarbital 60mg/1 ![Compare how all Medicare Part D PDP plans in IN cover Phenobarbital 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENOBARBITAL 64.8 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PHENOBARBITAL 64.8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENOBARBITAL 97.2 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PHENOBARBITAL 97.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENOXYBENZAMINE HCL 10 MG Capsule [Dibenzyline] ![Compare how all Medicare Part D PDP plans in IN cover PHENOXYBENZAMINE HCL 10 MG Capsule [Dibenzyline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
PHENYTEK 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PHENYTEK 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENYTEK 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PHENYTEK 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Phenytoin 50 MG Chewable Tablet ![Compare how all Medicare Part D PDP plans in IN cover Phenytoin 50 MG Chewable Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENYTOIN SOD EXT 100 MG CAP ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN SOD EXT 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENYTOIN SOD EXT 200 MG CAP ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN SOD EXT 200 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENYTOIN SOD EXT 300 MG CAP ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN SOD EXT 300 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PHENYTOIN SODIUM 100MG /2ML INJECTION ![Compare how all Medicare Part D PDP plans in IN cover PHENYTOIN SODIUM 100MG /2ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Phoslyra 667mg/5mL 1 BOTTLE per CARTON / 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Phoslyra 667mg/5mL 1 BOTTLE per CARTON / 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PHOSPHOLINE IODIDE 0.125% 6.25MG ![Compare how all Medicare Part D PDP plans in IN cover PHOSPHOLINE IODIDE 0.125% 6.25MG .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PHYSIOLYTE SOLUTION FOR IRRIGATION ![Compare how all Medicare Part D PDP plans in IN cover PHYSIOLYTE SOLUTION FOR IRRIGATION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PICATO 0.015% GEL ![Compare how all Medicare Part D PDP plans in IN cover PICATO 0.015% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PICATO 0.05% GEL ![Compare how all Medicare Part D PDP plans in IN cover PICATO 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PILOCARPINE 1% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE 1% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PILOCARPINE 2% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE 2% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PILOCARPINE 4% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE 4% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PILOCARPINE HCL 5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE HCL 5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PILOCARPINE HCL 7.5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in IN cover PILOCARPINE HCL 7.5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIMOZIDE 1 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in IN cover PIMOZIDE 1 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIMOZIDE 2 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in IN cover PIMOZIDE 2 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIMTREA 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in IN cover PIMTREA 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PINDOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PINDOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PINDOLOL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PINDOLOL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
pioglitaz-glimepir 30-2 mg tab ![Compare how all Medicare Part D PDP plans in IN cover pioglitaz-glimepir 30-2 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE HCL 15 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in IN cover PIOGLITAZONE HCL 15 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:90 /30Days |
PIOGLITAZONE HCL 30 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in IN cover PIOGLITAZONE HCL 30 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE HCL 45 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in IN cover PIOGLITAZONE HCL 45 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact] ![Compare how all Medicare Part D PDP plans in IN cover PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIOGLITAZONE-METFORMIN 15-500 ![Compare how all Medicare Part D PDP plans in IN cover PIOGLITAZONE-METFORMIN 15-500.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:90 /30Days |
PIOGLITAZONE-METFORMIN 15-850 ![Compare how all Medicare Part D PDP plans in IN cover PIOGLITAZONE-METFORMIN 15-850.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:90 /30Days |
PIPERACIL-TAZOBACT 2.25 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover PIPERACIL-TAZOBACT 2.25 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIPERACIL-TAZOBACT 3.375 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover PIPERACIL-TAZOBACT 3.375 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIPERACIL-TAZOBACT 4.5 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover PIPERACIL-TAZOBACT 4.5 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIPERACIL-TAZOBACT 40.5 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover PIPERACIL-TAZOBACT 40.5 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Pirmella 1-35-28 tablet ![Compare how all Medicare Part D PDP plans in IN cover Pirmella 1-35-28 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PIROXICAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PIROXICAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PIROXICAM 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PIROXICAM 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PLASMA-LYTE 148 IV SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PLASMA-LYTE 148 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML; ![Compare how all Medicare Part D PDP plans in IN cover PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
POLYETHYLENE GLYCOL 3350 POWD ![Compare how all Medicare Part D PDP plans in IN cover POLYETHYLENE GLYCOL 3350 POWD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
POLYMYXIN B SULFATE VIAL ![Compare how all Medicare Part D PDP plans in IN cover POLYMYXIN B SULFATE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
POLYMYXIN B-TMP EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover POLYMYXIN B-TMP EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
POMALYST 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover POMALYST 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
POMALYST 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover POMALYST 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
POMALYST 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover POMALYST 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
POMALYST 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover POMALYST 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
POT CHL/SWFI P-B 40 MEQ 24X100 ML ![Compare how all Medicare Part D PDP plans in IN cover POT CHL/SWFI P-B 40 MEQ 24X100 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Potassium Chloride 2 MEQ/ML Injectable Solution ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride 2 MEQ/ML Injectable Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Potassium Chloride 200 meq/1000mL 24 POUCH in 1 CASE ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride 200 meq/1000mL 24 POUCH in 1 CASE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Potassium Chloride 8 MEQ Extended Release Oral Tablet ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride 8 MEQ Extended Release Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.33g/100mL; g/100mL; g/100mL 12 CONTAI ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.33g/100mL; g/100mL; g/100mL 12 CONTAI.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Potassium Chloride in Lactated Ringers and Dextrose 20; 5; 179; 600; 310mg/100mL; g/100mL; mg/100mL ![Compare how all Medicare Part D PDP plans in IN cover Potassium Chloride in Lactated Ringers and Dextrose 20; 5; 179; 600; 310mg/100mL; g/100mL; mg/100mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
POTASSIUM CHLORIDE INJECTION 10MEQ/100ML ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CHLORIDE INJECTION 10MEQ/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
POTASSIUM CITRATE ER 10 MEQ TB ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CITRATE ER 10 MEQ TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
POTASSIUM CITRATE ER 15 MEQ TABLET ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CITRATE ER 15 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CITRATE ER 5 MEQ TAB ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CITRATE ER 5 MEQ TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Potassium cl 10% (20 meq/15 ml) ![Compare how all Medicare Part D PDP plans in IN cover Potassium cl 10% (20 meq/15 ml).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Potassium cl 20% (40 meq/15 ml) ![Compare how all Medicare Part D PDP plans in IN cover Potassium cl 20% (40 meq/15 ml).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
POTASSIUM CL 40 MEQ/20 ML CONC ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CL 40 MEQ/20 ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
POTASSIUM CL ER 10 MEQ CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CL ER 10 MEQ CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CL ER 10 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CL ER 10 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
POTASSIUM CL ER 20 MEQ TABLET ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CL ER 20 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Potassium cl er 20 meq tablet ![Compare how all Medicare Part D PDP plans in IN cover Potassium cl er 20 meq tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
POTASSIUM CL ER 8 MEQ CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover POTASSIUM CL ER 8 MEQ CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PRADAXA 110 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRADAXA 110 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRADAXA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRADAXA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days |
PRADAXA 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRADAXA 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days |
PRALUENT 150 MG/ML PEN ![Compare how all Medicare Part D PDP plans in IN cover PRALUENT 150 MG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:2 /28Days |
PRALUENT 75 MG/ML PEN ![Compare how all Medicare Part D PDP plans in IN cover PRALUENT 75 MG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:2 /28Days |
PRAMIPEXOLE 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRAMIPEXOLE 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAMIPEXOLE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRAMIPEXOLE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAMIPEXOLE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRAMIPEXOLE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAMIPEXOLE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRAMIPEXOLE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAMIPEXOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRAMIPEXOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAMIPEXOLE 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRAMIPEXOLE 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRASUGREL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRASUGREL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRASUGREL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRASUGREL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 10 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 20 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 40 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 40 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 80 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PRAVASTATIN SODIUM 80 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | Q:30 /30Days |
PRAZOSIN 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRAZOSIN 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAZOSIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRAZOSIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in IN cover PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PRED MILD 0.12% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover PRED MILD 0.12% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PRED-G S.O.P. EYE OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover PRED-G S.O.P. EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Prednicarbate 0.1% cream ![Compare how all Medicare Part D PDP plans in IN cover Prednicarbate 0.1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Prednisolone 10 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in IN cover Prednisolone 10 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISOLONE 15 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE 15 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISOLONE 20 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE 20 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISOLONE AC 1% EYE DROP ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE AC 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISOLONE SOD PH 25 MG/5 ML ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE SOD PH 25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Prednisone 10 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in IN cover Prednisone 10 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 10 MG TAB DOSE PACK ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 10 MG TAB DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 10 MG TAB DOSE PACK ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 10 MG TAB DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
Prednisone 20 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in IN cover Prednisone 20 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 5 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $0.00 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PREGNYL INJ 10000UNT ![Compare how all Medicare Part D PDP plans in IN cover PREGNYL INJ 10000UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMARIN 0.3 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREMARIN 0.625 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.625 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
Premarin 0.625mg/g ![Compare how all Medicare Part D PDP plans in IN cover Premarin 0.625mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PREMARIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREMARIN 1.25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMARIN 1.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PREMPHASE 0.625-5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMPHASE 0.625-5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREMPRO 0.3 MG-1.5 MG TABLET #28 EA ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.3 MG-1.5 MG TABLET #28 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREMPRO 0.45-1.5 MG TABLET 28 EA ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.45-1.5 MG TABLET 28 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMPRO 0.625-5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREMPRO 0.625-5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
Prempro 0.625; 2.5mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, SUGAR COATED per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IN cover Prempro 0.625; 2.5mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, SUGAR COATED per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:30 /30Days |
PREVALITE PACKET ![Compare how all Medicare Part D PDP plans in IN cover PREVALITE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Previfem 6 BLISTER PACK per BLISTER PACK / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IN cover Previfem 6 BLISTER PACK per BLISTER PACK / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PREZCOBIX 800 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREZCOBIX 800 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:60 /30Days |
PREZISTA 100 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA 100 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:1800 /30Days |
PREZISTA 150MG TABLETS ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:180 /30Days |
PREZISTA 800 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in IN cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:210 /30Days |
PRIFTIN 150 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRIFTIN 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRILOSEC DR 10 MG SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover PRILOSEC DR 10 MG SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PRILOSEC DR 2.5 MG SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover PRILOSEC DR 2.5 MG SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Primaquine Phosphate 26.3 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in IN cover Primaquine Phosphate 26.3 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PRIMIDONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRIMIDONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRIMIDONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRIMIDONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PRISTIQ 100MG TABLET SR 24HR ![Compare how all Medicare Part D PDP plans in IN cover PRISTIQ 100MG TABLET SR 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P Q:120 /30Days |
PRISTIQ ER 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PRISTIQ ER 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P Q:30 /30Days |
PRISTIQ ER 50 MG TABLET ER 24H ![Compare how all Medicare Part D PDP plans in IN cover PRISTIQ ER 50 MG TABLET ER 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P Q:30 /30Days |
PRIVIGEN 10% VIAL ![Compare how all Medicare Part D PDP plans in IN cover PRIVIGEN 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PROAIR HFA 90 MCG INHALER ![Compare how all Medicare Part D PDP plans in IN cover PROAIR HFA 90 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PROAIR RESPICLICK INHAL POWDER ![Compare how all Medicare Part D PDP plans in IN cover PROAIR RESPICLICK INHAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROBENECID 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROBENECID 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROBENECID/COLCHICINE 0.5MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROBENECID/COLCHICINE 0.5MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROCAINAMIDE 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCAINAMIDE 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROCAINAMIDE 500MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCAINAMIDE 500MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
ProcalAmine 0.21; 0.29; 0.026; 0.014; 3; 0.42; 0.085; 0.21; 0.27; 0.22; 0.054; 0.16; 0.17; 0.041; 0 ![Compare how all Medicare Part D PDP plans in IN cover ProcalAmine 0.21; 0.29; 0.026; 0.014; 3; 0.42; 0.085; 0.21; 0.27; 0.22; 0.054; 0.16; 0.17; 0.041; 0.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PROCHLORPERAZINE 10 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Prochlorperazine 10 mg/2 ml vl ![Compare how all Medicare Part D PDP plans in IN cover Prochlorperazine 10 mg/2 ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROCHLORPERAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in IN cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCRIT 3,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 3,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PROCRIT 4,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 4,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in IN cover PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PROCTO-MED HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PROCTO-MED HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
procto-pak 1% cream ![Compare how all Medicare Part D PDP plans in IN cover procto-pak 1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IN cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROCYSBI DR 25 MG CAPSULE CAP DR SPR ![Compare how all Medicare Part D PDP plans in IN cover PROCYSBI DR 25 MG CAPSULE CAP DR SPR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
PROCYSBI DR 75 MG CAPSULE CAP DR SPR ![Compare how all Medicare Part D PDP plans in IN cover PROCYSBI DR 75 MG CAPSULE CAP DR SPR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
PROGESTERONE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROGESTERONE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROGESTERONE 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROGESTERONE 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROGLYCEM 50 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover PROGLYCEM 50 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
PROGRAF 5MG/ML AMPULE ![Compare how all Medicare Part D PDP plans in IN cover PROGRAF 5MG/ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
PROLASTIN C 1,000 MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROLASTIN C 1,000 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PROLENSA 0.07% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover PROLENSA 0.07% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROLEUKIN 22 MILLION UNIT VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROLEUKIN 22 MILLION UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PROLIA 60MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in IN cover PROLIA 60MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROMACTA 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMACTA 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
PROMACTA 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMACTA 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
PROMACTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMACTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:60 /30Days |
PROMACTA 75 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMACTA 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMETHAZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PROMETHAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PROMETHAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PROMETHAZINE 50 MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE 50 MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain] ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PROMETHAZINE HYDROCHLORIDE 25mg/mL 25 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HYDROCHLORIDE 25mg/mL 25 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in IN cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in IN cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROPAFENONE HCL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPAFENONE HCL 300 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL 300 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPAFENONE HCL ER 225 MG CAP ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HCL ER 225 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in IN cover PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Proparacaine hydrochloride 5 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in IN cover Proparacaine hydrochloride 5 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL 1 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 1 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROPRANOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL 80 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL ER 160 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL ER 160 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL ER 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL ER 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$8.00 | $0.00 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in IN cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PROSOL 20% INJECTION ![Compare how all Medicare Part D PDP plans in IN cover PROSOL 20% INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROTRIPTYLINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROTRIPTYLINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PROTRIPTYLINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PROTRIPTYLINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
Prudoxin 5% cream ![Compare how all Medicare Part D PDP plans in IN cover Prudoxin 5% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IN cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:150 /30Days |
PURIXAN 20 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in IN cover PURIXAN 20 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
PYRAZINAMIDE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PYRAZINAMIDE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |
PYRIDOSTIGMINE BR 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover PYRIDOSTIGMINE BR 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
PYRIDOSTIGMINE BR ER 180 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover PYRIDOSTIGMINE BR ER 180 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None |