2018 Medicare Part D Plan Formulary Information |
Express Scripts Medicare - Value (PDP) (S5660-127-0)
Benefit Details
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The Express Scripts Medicare - Value (PDP) (S5660-127-0) Formulary Drugs Starting with the Letter P in CMS PDP Region 25 which includes: IA MN MT NE ND SD WY Plan Monthly Premium: $48.50 Deductible: $405 Qualifies for LIS: No |
Drugs Starting with Letter P
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
PACERONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PACERONE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PACERONE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PACLITAXEL 100 MG/16.7 ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PACLITAXEL 100 MG/16.7 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P |
PALIPERIDONE ER 1.5 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in SD cover PALIPERIDONE ER 1.5 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P Q:248 /31Days |
PALIPERIDONE ER 3 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in SD cover PALIPERIDONE ER 3 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P Q:124 /31Days |
PALIPERIDONE ER 6 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in SD cover PALIPERIDONE ER 6 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P Q:62 /31Days |
PALIPERIDONE ER 9 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in SD cover PALIPERIDONE ER 9 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P Q:42 /31Days |
PALONOSETRON 0.25 MG/5 ML VIAL [Aloxi] ![Compare how all Medicare Part D PDP plans in SD cover PALONOSETRON 0.25 MG/5 ML VIAL [Aloxi].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PALYNZIQ 10 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover PALYNZIQ 10 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PALYNZIQ 2.5 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover PALYNZIQ 2.5 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PALYNZIQ 20 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in SD cover PALYNZIQ 20 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in SD cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PANTOPRAZOLE SOD DR 20 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PANTOPRAZOLE SOD DR 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | Q:31 /31Days |
PANTOPRAZOLE SOD DR 40 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PANTOPRAZOLE SOD DR 40 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PARICALCITOL 1 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in SD cover PARICALCITOL 1 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PARICALCITOL 10 MCG/2 ML VIAL [Zemplar] ![Compare how all Medicare Part D PDP plans in SD cover PARICALCITOL 10 MCG/2 ML VIAL [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PARICALCITOL 2 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in SD cover PARICALCITOL 2 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PARICALCITOL 2 MCG/ML VIAL [Zemplar] ![Compare how all Medicare Part D PDP plans in SD cover PARICALCITOL 2 MCG/ML VIAL [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PARICALCITOL 4 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in SD cover PARICALCITOL 4 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PAROMOMYCIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PAROMOMYCIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PAROXETINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PAROXETINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:186 /31Days |
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 SD cover PAROXETINE HCL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:93 /31Days |
PAROXETINE HCL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PAROXETINE HCL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:62 /31Days |
PAROXETINE HCL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PAROXETINE HCL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:47 /31Days |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in SD cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PATADAY 0.2% DROPS ![Compare how all Medicare Part D PDP plans in SD cover PATADAY 0.2% DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PAXIL ORAL SUSPENSION 10 MG/5ML ![Compare how all Medicare Part D PDP plans in SD cover PAXIL ORAL SUSPENSION 10 MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PAZEO 0.7% EYE DROPS ![Compare how all Medicare Part D PDP plans in SD cover PAZEO 0.7% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in SD cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PEG 3350 ELECTROLYTE SOLN SOLN RECON [GaviLyte-C] ![Compare how all Medicare Part D PDP plans in SD cover PEG 3350 ELECTROLYTE SOLN SOLN RECON [GaviLyte-C].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PEG 3350-ELECTROLYTE SOLUTION SOLN RECON ![Compare how all Medicare Part D PDP plans in SD cover PEG 3350-ELECTROLYTE SOLUTION SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PEG-3350 AND ELECTROLYTES SOLN SOLN RECON ![Compare how all Medicare Part D PDP plans in SD cover PEG-3350 AND ELECTROLYTES SOLN SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEGANONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PEGANONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
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 SD 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 |
25% | N/A | Q:2 /28Days |
PEGASYS INJECTION ![Compare how all Medicare Part D PDP plans in SD cover PEGASYS INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:4 /28Days |
PEGASYS PROCLICK 180 MCG/0.5 ![Compare how all Medicare Part D PDP plans in SD cover PEGASYS PROCLICK 180 MCG/0.5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:2 /28Days |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in SD cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | 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 SD 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 |
48% | N/A | None |
PENICILLIN GK 20 MILLION UNIT ![Compare how all Medicare Part D PDP plans in SD cover PENICILLIN GK 20 MILLION UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in SD cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PENICILLIN V POTASSIUM 500MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PENICILLIN V POTASSIUM 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PENICILLIN VK 125 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in SD cover PENICILLIN VK 125 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PENICILLIN VK 250 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PENICILLIN VK 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | 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 SD cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in SD cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in SD cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PERFOROMIST 20MCG/2ML VIAL NEBULIZER ![Compare how all Medicare Part D PDP plans in SD cover PERFOROMIST 20MCG/2ML VIAL NEBULIZER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PERIOGARD 0.12% ORAL RINSE ![Compare how all Medicare Part D PDP plans in SD cover PERIOGARD 0.12% ORAL RINSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PERJETA 420 MG/14 ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PERJETA 420 MG/14 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in SD cover Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Perphenazine 16mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in SD 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 |
48% | N/A | None |
PERPHENAZINE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PERPHENAZINE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PERPHENAZINE 8 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PERPHENAZINE 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERPHENAZINE TABLETS USP 2MG 100 BOT ![Compare how all Medicare Part D PDP plans in SD cover PERPHENAZINE TABLETS USP 2MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in SD cover Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Phenobarbital 100mg/1 ![Compare how all Medicare Part D PDP plans in SD cover Phenobarbital 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
Phenobarbital 15mg/1 ![Compare how all Medicare Part D PDP plans in SD cover Phenobarbital 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PHENOBARBITAL 16.2 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PHENOBARBITAL 16.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PHENOBARBITAL 20 MG/5 ML ELIX ![Compare how all Medicare Part D PDP plans in SD cover PHENOBARBITAL 20 MG/5 ML ELIX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
Phenobarbital 30mg/1 ![Compare how all Medicare Part D PDP plans in SD cover Phenobarbital 30mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PHENOBARBITAL 32.4 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PHENOBARBITAL 32.4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
Phenobarbital 60mg/1 ![Compare how all Medicare Part D PDP plans in SD cover Phenobarbital 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PHENOBARBITAL 64.8 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PHENOBARBITAL 64.8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PHENOBARBITAL 97.2 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PHENOBARBITAL 97.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Phenytoin 50 MG Chewable Tablet ![Compare how all Medicare Part D PDP plans in SD cover Phenytoin 50 MG Chewable Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT ![Compare how all Medicare Part D PDP plans in SD cover PHENYTOIN ORAL SUSPENSION 125MG 8 OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PHENYTOIN SOD EXT 100 MG CAP ![Compare how all Medicare Part D PDP plans in SD cover PHENYTOIN SOD EXT 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PHENYTOIN SOD EXT 200 MG CAP ![Compare how all Medicare Part D PDP plans in SD cover PHENYTOIN SOD EXT 200 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PHENYTOIN SOD EXT 300 MG CAP ![Compare how all Medicare Part D PDP plans in SD cover PHENYTOIN SOD EXT 300 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PHENYTOIN SODIUM 100MG /2ML INJECTION ![Compare how all Medicare Part D PDP plans in SD cover PHENYTOIN SODIUM 100MG /2ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PHOSPHOLINE IODIDE 0.125% 6.25MG ![Compare how all Medicare Part D PDP plans in SD cover PHOSPHOLINE IODIDE 0.125% 6.25MG .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PILOCARPINE 1% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in SD cover PILOCARPINE 1% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PILOCARPINE 2% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in SD cover PILOCARPINE 2% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PILOCARPINE 4% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in SD cover PILOCARPINE 4% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PILOCARPINE HCL 5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in SD cover PILOCARPINE HCL 5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | 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 SD cover PILOCARPINE HCL 7.5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PIMOZIDE 1 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in SD cover PIMOZIDE 1 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PIMOZIDE 2 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in SD cover PIMOZIDE 2 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PIMTREA 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in SD cover PIMTREA 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PINDOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PINDOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PINDOLOL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PINDOLOL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PIOGLITAZONE HCL 15 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in SD cover PIOGLITAZONE HCL 15 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | Q:31 /31Days |
PIOGLITAZONE HCL 30 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in SD cover PIOGLITAZONE HCL 30 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | Q:31 /31Days |
PIOGLITAZONE HCL 45 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in SD cover PIOGLITAZONE HCL 45 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | Q:31 /31Days |
PIPERACIL-TAZOBACT 2.25 GM VIAL ![Compare how all Medicare Part D PDP plans in SD cover PIPERACIL-TAZOBACT 2.25 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PIPERACIL-TAZOBACT 3.375 GM VIAL ![Compare how all Medicare Part D PDP plans in SD cover PIPERACIL-TAZOBACT 3.375 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIPERACIL-TAZOBACT 4.5 GM VIAL ![Compare how all Medicare Part D PDP plans in SD cover PIPERACIL-TAZOBACT 4.5 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PIPERACIL-TAZOBACT 40.5 GM VIAL ![Compare how all Medicare Part D PDP plans in SD cover PIPERACIL-TAZOBACT 40.5 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Pirmella 1-35-28 tablet ![Compare how all Medicare Part D PDP plans in SD cover Pirmella 1-35-28 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PIROXICAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PIROXICAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PIROXICAM 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PIROXICAM 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in SD cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
POLYETHYLENE GLYCOL 3350 POWD ![Compare how all Medicare Part D PDP plans in SD cover POLYETHYLENE GLYCOL 3350 POWD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
POLYMYXIN B-TMP EYE DROPS ![Compare how all Medicare Part D PDP plans in SD cover POLYMYXIN B-TMP EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
POMALYST 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover POMALYST 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
POMALYST 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover POMALYST 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
POMALYST 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover POMALYST 3 MG 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 |
POMALYST 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover POMALYST 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in SD cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
POT CHL/SWFI P-B 40 MEQ 24X100 ML ![Compare how all Medicare Part D PDP plans in SD cover POT CHL/SWFI P-B 40 MEQ 24X100 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Potassium Chloride 2 MEQ/ML Injectable Solution ![Compare how all Medicare Part D PDP plans in SD cover Potassium Chloride 2 MEQ/ML Injectable Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Potassium Chloride 200 meq/1000mL 24 POUCH in 1 CASE ![Compare how all Medicare Part D PDP plans in SD cover Potassium Chloride 200 meq/1000mL 24 POUCH in 1 CASE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Potassium Chloride 8 MEQ Extended Release Oral Tablet ![Compare how all Medicare Part D PDP plans in SD cover Potassium Chloride 8 MEQ Extended Release Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CHLORIDE IN 5% DEXTROSE AND SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in SD 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) |
2 |
Generic |
$3.00 | $9.00 | None |
Potassium Chloride in Dextrose and Sodium Chloride 5; 0.15; 0.33g/100mL; g/100mL; g/100mL 12 CONTAI ![Compare how all Medicare Part D PDP plans in SD 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) |
2 |
Generic |
$3.00 | $9.00 | 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 SD 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) |
2 |
Generic |
$3.00 | $9.00 | 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 SD 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) |
2 |
Generic |
$3.00 | $9.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CHLORIDE IN SODIUM CHLORIDE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
POTASSIUM CHLORIDE INJECTION 10MEQ/100ML ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CHLORIDE INJECTION 10MEQ/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
POTASSIUM CITRATE ER 10 MEQ TB ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CITRATE ER 10 MEQ TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
POTASSIUM CITRATE ER 15 MEQ TABLET ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CITRATE ER 15 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
POTASSIUM CITRATE ER 5 MEQ TAB ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CITRATE ER 5 MEQ TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Potassium cl 10% (20 meq/15 ml) ![Compare how all Medicare Part D PDP plans in SD cover Potassium cl 10% (20 meq/15 ml).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Potassium cl 20% (40 meq/15 ml) ![Compare how all Medicare Part D PDP plans in SD cover Potassium cl 20% (40 meq/15 ml).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
POTASSIUM CL 40 MEQ/20 ML CONC ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CL 40 MEQ/20 ML CONC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
POTASSIUM CL ER 10 MEQ CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CL ER 10 MEQ CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CL ER 10 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CL ER 10 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CL ER 20 MEQ TABLET ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CL ER 20 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
Potassium cl er 20 meq tablet ![Compare how all Medicare Part D PDP plans in SD cover Potassium cl er 20 meq tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
POTASSIUM CL ER 8 MEQ CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover POTASSIUM CL ER 8 MEQ CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRALUENT 150 MG/ML PEN ![Compare how all Medicare Part D PDP plans in SD cover PRALUENT 150 MG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:2 /28Days |
PRALUENT 75 MG/ML PEN ![Compare how all Medicare Part D PDP plans in SD cover PRALUENT 75 MG/ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
PRAMIPEXOLE 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRAMIPEXOLE 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAMIPEXOLE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRAMIPEXOLE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAMIPEXOLE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRAMIPEXOLE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAMIPEXOLE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRAMIPEXOLE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAMIPEXOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRAMIPEXOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAMIPEXOLE 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRAMIPEXOLE 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRASUGREL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRASUGREL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PRASUGREL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRASUGREL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PRAVASTATIN SODIUM 10 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PRAVASTATIN SODIUM 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:31 /31Days |
PRAVASTATIN SODIUM 20 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PRAVASTATIN SODIUM 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:31 /31Days |
PRAVASTATIN SODIUM 40 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PRAVASTATIN SODIUM 40 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:31 /31Days |
PRAVASTATIN SODIUM 80 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PRAVASTATIN SODIUM 80 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:31 /31Days |
PRAZOSIN 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PRAZOSIN 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAZOSIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PRAZOSIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
Prednicarbate 0.1% cream ![Compare how all Medicare Part D PDP plans in SD cover Prednicarbate 0.1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PREDNICARBATE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in SD cover PREDNICARBATE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Prednisolone 10 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in SD cover Prednisolone 10 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PREDNISOLONE 15 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in SD cover PREDNISOLONE 15 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PREDNISOLONE 20 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in SD cover PREDNISOLONE 20 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PREDNISOLONE AC 1% EYE DROP ![Compare how all Medicare Part D PDP plans in SD cover PREDNISOLONE AC 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Prednisolone odt 10 mg tablet ![Compare how all Medicare Part D PDP plans in SD cover Prednisolone odt 10 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P |
Prednisolone odt 15 mg tablet ![Compare how all Medicare Part D PDP plans in SD cover Prednisolone odt 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
Prednisolone odt 30 mg tablet ![Compare how all Medicare Part D PDP plans in SD cover Prednisolone odt 30 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in SD cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PREDNISOLONE SOD PH 25 MG/5 ML ![Compare how all Medicare Part D PDP plans in SD cover PREDNISOLONE SOD PH 25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PREDNISONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Prednisone 10 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in SD cover Prednisone 10 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
PREDNISONE 10 MG TAB DOSE PACK ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 10 MG TAB DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PREDNISONE 10 MG TAB DOSE PACK ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 10 MG TAB DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PREDNISONE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
Prednisone 20 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in SD cover Prednisone 20 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
PREDNISONE 5 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 5 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | 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 SD cover PREMARIN 0.3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREMARIN 0.45MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREMARIN 0.45MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREMARIN 0.625 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREMARIN 0.625 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Premarin 0.625mg/g ![Compare how all Medicare Part D PDP plans in SD cover Premarin 0.625mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PREMARIN 0.9MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREMARIN 0.9MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREMARIN 1.25 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREMARIN 1.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | P |
PREMASOL 6% IV SOLUTION ![Compare how all Medicare Part D PDP plans in SD cover PREMASOL 6% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PREMPHASE 0.625-5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREMPHASE 0.625-5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PREMPRO 0.3 MG-1.5 MG TABLET #28 EA ![Compare how all Medicare Part D PDP plans in SD cover PREMPRO 0.3 MG-1.5 MG TABLET #28 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREMPRO 0.45-1.5 MG TABLET 28 EA ![Compare how all Medicare Part D PDP plans in SD cover PREMPRO 0.45-1.5 MG TABLET 28 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
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 SD cover PREMPRO 0.625-5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
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 SD 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) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREPOPIK POWDER PACKET ![Compare how all Medicare Part D PDP plans in SD cover PREPOPIK POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PREVALITE PACKET ![Compare how all Medicare Part D PDP plans in SD cover PREVALITE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Previfem 6 BLISTER PACK per BLISTER PACK / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in SD 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 |
48% | N/A | None |
PREVYMIS 20 MG 12 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in SD cover PREVYMIS 20 MG 12 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PREVYMIS 20 MG 24 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in SD cover PREVYMIS 20 MG 24 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PREVYMIS 240 MG ![Compare how all Medicare Part D PDP plans in SD cover PREVYMIS 240 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PREVYMIS 480 MG ![Compare how all Medicare Part D PDP plans in SD cover PREVYMIS 480 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PREZCOBIX 800 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREZCOBIX 800 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PREZISTA 100 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in SD cover PREZISTA 100 MG/ML SUSPENSION.](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 |
PREZISTA 150MG TABLETS ![Compare how all Medicare Part D PDP plans in SD cover PREZISTA 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PREZISTA 800 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PREZISTA 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in SD cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in SD cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PRIFTIN 150 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRIFTIN 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
Primaquine Phosphate 26.3 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in SD cover Primaquine Phosphate 26.3 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PRIMIDONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRIMIDONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRIMIDONE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PRIMIDONE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PRIVIGEN 10% VIAL ![Compare how all Medicare Part D PDP plans in SD cover PRIVIGEN 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PROAIR HFA 90 MCG INHALER ![Compare how all Medicare Part D PDP plans in SD cover PROAIR HFA 90 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | Q:17 /30Days |
PROAIR RESPICLICK INHAL POWDER ![Compare how all Medicare Part D PDP plans in SD cover PROAIR RESPICLICK INHAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | Q:2 /30Days |
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 SD cover PROBENECID 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROBENECID/COLCHICINE 0.5MG/500MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROBENECID/COLCHICINE 0.5MG/500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROCAINAMIDE 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROCAINAMIDE 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROCAINAMIDE 500MG/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROCAINAMIDE 500MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROCHLORPERAZINE 10 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PROCHLORPERAZINE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Prochlorperazine 10 mg/2 ml vl ![Compare how all Medicare Part D PDP plans in SD cover Prochlorperazine 10 mg/2 ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROCHLORPERAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROCHLORPERAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in SD cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PROCRIT 3,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROCRIT 3,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCRIT 4,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROCRIT 4,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in SD cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in SD 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 |
25% | N/A | P |
PROCTO-MED HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in SD cover PROCTO-MED HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
procto-pak 1% cream ![Compare how all Medicare Part D PDP plans in SD cover procto-pak 1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in SD cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in SD cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROFENO 600 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROFENO 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PROGLYCEM 50 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in SD cover PROGLYCEM 50 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
PROGRAF 5MG/ML AMPULE ![Compare how all Medicare Part D PDP plans in SD cover PROGRAF 5MG/ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | P |
PROLASTIN C 1,000 MG VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROLASTIN C 1,000 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROLENSA 0.07% EYE DROPS ![Compare how all Medicare Part D PDP plans in SD cover PROLENSA 0.07% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PROLEUKIN 22 MILLION UNIT VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROLEUKIN 22 MILLION UNIT VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P |
PROLIA 60MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in SD cover PROLIA 60MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | P |
PROMACTA 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROMACTA 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PROMACTA 25 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROMACTA 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PROMACTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROMACTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PROMACTA 75 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROMACTA 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PROPAFENONE HCL 150 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPAFENONE HCL 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROPAFENONE HCL 300 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PROPAFENONE HCL 300 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPAFENONE HCL ER 225 MG CAP ![Compare how all Medicare Part D PDP plans in SD cover PROPAFENONE HCL ER 225 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in SD cover PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in SD cover PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPRANOLOL 1 MG/ML VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 1 MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROPRANOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PROPRANOLOL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROPRANOLOL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROPRANOLOL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PROPRANOLOL 80 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
PROPRANOLOL ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL ER 160 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL ER 160 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPRANOLOL ER 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL ER 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPRANOLOL ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$3.00 | $9.00 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in SD cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PROTRIPTYLINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROTRIPTYLINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PROTRIPTYLINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PROTRIPTYLINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in SD cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
PURIXAN 20 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in SD cover PURIXAN 20 MG/ML ORAL SUSP.](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 |
PYRAZINAMIDE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PYRAZINAMIDE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
48% | N/A | None |
PYRIDOSTIGMINE BR 60 MG TABLET ![Compare how all Medicare Part D PDP plans in SD cover PYRIDOSTIGMINE BR 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |
PYRIDOSTIGMINE BR ER 180 MG TAB ![Compare how all Medicare Part D PDP plans in SD cover PYRIDOSTIGMINE BR ER 180 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$20.00 | $60.00 | None |