2019 Medicare Part D Plan Formulary Information |
UPMC for Life Dual (HMO SNP) (H4279-001-0)
Benefit Details
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The UPMC for Life Dual (HMO SNP) (H4279-001-0) Formulary Drugs Starting with the Letter M in Mercer County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $37.00 Deductible: $415 |
Drugs Starting with Letter M
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML ![Compare how all Medicare Part D PDP plans in PA cover M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
MAGNESIUM SULFATE 50% VIAL ![Compare how all Medicare Part D PDP plans in PA cover MAGNESIUM SULFATE 50% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MAGNESIUM SULFATE INJECTION 5 GM/10ML ![Compare how all Medicare Part D PDP plans in PA cover MAGNESIUM SULFATE INJECTION 5 GM/10ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MALATHION 0.5% LOTION ![Compare how all Medicare Part D PDP plans in PA cover MALATHION 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MAPROTILINE 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MAPROTILINE 50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MAPROTILINE 75MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAPROTILINE 75MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MARLISSA-28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover MARLISSA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MARPLAN 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover MARPLAN 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MATULANE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MATULANE 50 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 |
MAVYRET 100-40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAVYRET 100-40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:84 /28Days |
MAYZENT 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAYZENT 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
MAYZENT 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MAYZENT 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
MECLIZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MECLIZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MECLIZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MECLIZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MEDROXYPROGESTERONE 10 MG TABLET [Provera] ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 10 MG TABLET [Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MEDROXYPROGESTERONE 150 MG/ML Syringe [Depo-Provera] ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 150 MG/ML Syringe [Depo-Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:1 /84Days |
MEDROXYPROGESTERONE 150 MG/ML VIAL [Depo-Provera] ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 150 MG/ML VIAL [Depo-Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:1 /84Days |
MEDROXYPROGESTERONE 2.5 MG TABLET [Provera] ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 2.5 MG TABLET [Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MEDROXYPROGESTERONE 5 MG TABLET [Provera] ![Compare how all Medicare Part D PDP plans in PA cover MEDROXYPROGESTERONE 5 MG TABLET [Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MEFLOQUINE HCL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEFLOQUINE HCL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEGESTROL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
MEGESTROL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
MEGESTROL ACET 40 MG/ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover MEGESTROL ACET 40 MG/ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MEKINIST 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEKINIST 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
MEKINIST 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEKINIST 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
MEKTOVI 15 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MEKTOVI 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
MELOXICAM 15 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MELOXICAM 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MELOXICAM 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MELOXICAM 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MEMANTINE 5-10 MG TITRATION PK [Namenda Titration] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE 5-10 MG TITRATION PK [Namenda Titration].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | P Q:98 /365Days |
MEMANTINE HCL 10 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE HCL 10 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
MEMANTINE HCL 2 MG/ML SOLUTION [Namenda] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE HCL 2 MG/ML SOLUTION [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEMANTINE HCL 5 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in PA cover MEMANTINE HCL 5 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL ![Compare how all Medicare Part D PDP plans in PA cover Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MENEST 0.3MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MENEST 0.3MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MENEST 0.625MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MENEST 0.625MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MENEST 1.25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MENEST 1.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MENOSTAR 14 MCG/DAY PATCH ![Compare how all Medicare Part D PDP plans in PA cover MENOSTAR 14 MCG/DAY PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | Q:4 /28Days |
MENVEO A-C-Y-W-135-DIP VIAL ![Compare how all Medicare Part D PDP plans in PA cover MENVEO A-C-Y-W-135-DIP VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MERCAPTOPURINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MERCAPTOPURINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MEROPENEM 500MG/VIAL FOR INJECTION ![Compare how all Medicare Part D PDP plans in PA cover MEROPENEM 500MG/VIAL FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MEROPENEM IV 1 GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover MEROPENEM IV 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MESALAMINE 1,000 MG SUPP.RECT [Canasa] ![Compare how all Medicare Part D PDP plans in PA cover MESALAMINE 1,000 MG SUPP.RECT [Canasa].](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 |
MESALAMINE 4 GM/60 ML ENEMA ![Compare how all Medicare Part D PDP plans in PA cover MESALAMINE 4 GM/60 ML ENEMA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MESALAMINE 800 MG DR TABLET DR [Asacol HD] ![Compare how all Medicare Part D PDP plans in PA cover MESALAMINE 800 MG DR TABLET DR [Asacol HD].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MESALAMINE DR 1.2 GM TABLET ![Compare how all Medicare Part D PDP plans in PA cover MESALAMINE DR 1.2 GM TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MESALAMINE DR 400 MG CAPSULE (DRTAB) [Delzicol] ![Compare how all Medicare Part D PDP plans in PA cover MESALAMINE DR 400 MG CAPSULE (DRTAB) [Delzicol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MESNEX 400MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MESNEX 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METFORMIN HCL 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | Q:75 /30Days |
METFORMIN HCL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | Q:150 /30Days |
METFORMIN HCL 850 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL 850 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | Q:90 /30Days |
METFORMIN HCL ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | Q:120 /30Days |
METFORMIN HCL ER 750 MG TABLET ER 24H [Glucophage XR] ![Compare how all Medicare Part D PDP plans in PA cover METFORMIN HCL ER 750 MG TABLET ER 24H [Glucophage XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | Q:60 /30Days |
METHAMPHETAMINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHAMPHETAMINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:150 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Methazolamide 25 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in PA cover Methazolamide 25 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METHAZOLAMIDE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHAZOLAMIDE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
Methenamine Hippurate 1g/1 ![Compare how all Medicare Part D PDP plans in PA cover Methenamine Hippurate 1g/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METHIMAZOLE 10 MG TABLET [Tapazole] ![Compare how all Medicare Part D PDP plans in PA cover METHIMAZOLE 10 MG TABLET [Tapazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHIMAZOLE 5 MG TABLET [Tapazole] ![Compare how all Medicare Part D PDP plans in PA cover METHIMAZOLE 5 MG TABLET [Tapazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHOCARBAMOL 500 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHOCARBAMOL 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
METHOCARBAMOL 750 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHOCARBAMOL 750 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
METHOTREXATE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHOTREXATE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
METHOTREXATE 250 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover METHOTREXATE 250 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
METHOTREXATE 50 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover METHOTREXATE 50 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P |
Methoxsalen 10 mg Capsule [8-MOP] ![Compare how all Medicare Part D PDP plans in PA cover Methoxsalen 10 mg Capsule [8-MOP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPHENIDATE 10 MG TABLET [Ritalin] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 10 MG TABLET [Ritalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P Q:90 /30Days |
METHYLPHENIDATE 10 MG/5 ML SOL Solution [Methylin] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 10 MG/5 ML SOL Solution [Methylin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:900 /30Days |
METHYLPHENIDATE 20 MG TABLET [Ritalin] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 20 MG TABLET [Ritalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P Q:150 /30Days |
METHYLPHENIDATE 5 MG TABLET [Ritalin] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 5 MG TABLET [Ritalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | P Q:90 /30Days |
METHYLPHENIDATE 5 MG/5 ML SOLN Solution [Methylin] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE 5 MG/5 ML SOLN Solution [Methylin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:1800 /30Days |
METHYLPHENIDATE CD 10 MG CAPSULE CPBP 30-70 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 10 MG CAPSULE CPBP 30-70 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE CD 20 MG CAPSULE CPBP 30-70 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 20 MG CAPSULE CPBP 30-70 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE CD 30 MG CAPSULE CPBP 30-70 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 30 MG CAPSULE CPBP 30-70 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE CD 40 MG CAPSULE CPBP 30-70 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 40 MG CAPSULE CPBP 30-70 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE CD 50 MG CAPSULE CPBP 30-70 [Metadate CD] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 50 MG CAPSULE CPBP 30-70 [Metadate CD].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE CD 60 MG CAPSULE CPBP 30-70 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE CD 60 MG CAPSULE CPBP 30-70 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPHENIDATE LA 20 MG CAPSULE CPBP 50-50 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE LA 20 MG CAPSULE CPBP 50-50 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE LA 30 MG CAP CPBP 50-50 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE LA 30 MG CAP CPBP 50-50 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPHENIDATE LA 40 MG CAPSULE CPBP 50-50 [Ritalin LA] ![Compare how all Medicare Part D PDP plans in PA cover METHYLPHENIDATE LA 40 MG CAPSULE CPBP 50-50 [Ritalin LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:30 /30Days |
METHYLPREDNISOLONE 16MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 16MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHYLPREDNISOLONE 32MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 32MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHYLPREDNISOLONE 4 MG DOSEPK ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 4 MG DOSEPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHYLPREDNISOLONE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHYLPREDNISOLONE 8 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in PA cover METHYLPREDNISOLONE 8 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METHYLTESTOSTERONE 10 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover METHYLTESTOSTERONE 10 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Metoclopramide 10mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Metoclopramide 10mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOCLOPRAMIDE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOCLOPRAMIDE 5 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in PA cover METOCLOPRAMIDE 5 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOLAZONE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METOLAZONE 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOLAZONE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOLAZONE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOPROLOL SUCC ER 100 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCC ER 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOPROLOL SUCC ER 200 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCC ER 200 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOPROLOL SUCC ER 25 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCC ER 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOPROLOL SUCC ER 50 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL SUCC ER 50 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METOPROLOL TARTRATE 100 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE 100 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
METOPROLOL TARTRATE 25 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE 25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 100MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover METOPROLOL-HYDROCHLOROTHIAZIDE 50MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METRONIDAZOLE 0.75% CREAM Cream (g) [Vitazol] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 0.75% CREAM Cream (g) [Vitazol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
METRONIDAZOLE 250 MG TABLET [Flagyl] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 250 MG TABLET [Flagyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METRONIDAZOLE 375 MG CAPSULE [Flagyl] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 375 MG CAPSULE [Flagyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METRONIDAZOLE 500 MG TABLET [Flagyl] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 500 MG TABLET [Flagyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
METRONIDAZOLE 500 MG/100 ML PIGGYBACK [Flagyl RTU] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE 500 MG/100 ML PIGGYBACK [Flagyl RTU].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
METRONIDAZOLE TOPICAL 0.75% GL Gel [Nydamax] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE TOPICAL 0.75% GL Gel [Nydamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
METRONIDAZOLE VAGINAL 0.75% GL GEL W/APPL [Vandazole] ![Compare how all Medicare Part D PDP plans in PA cover METRONIDAZOLE VAGINAL 0.75% GL GEL W/APPL [Vandazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MEXILETINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEXILETINE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MEXILETINE 250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MEXILETINE 250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MICONAZOLE 3 200MG SUPPOS. ![Compare how all Medicare Part D PDP plans in PA cover MICONAZOLE 3 200MG SUPPOS..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Microgestin 21 1-20 tablet ![Compare how all Medicare Part D PDP plans in PA cover Microgestin 21 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MICROGESTIN 21 1.5-30 TAB ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN 21 1.5-30 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Microgestin fe 1-20 tablet ![Compare how all Medicare Part D PDP plans in PA cover Microgestin fe 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MICROGESTIN FE 1.5-30 TAB ![Compare how all Medicare Part D PDP plans in PA cover MICROGESTIN FE 1.5-30 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIDODRINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIDODRINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MIDODRINE HCL 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIDODRINE HCL 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MIDODRINE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIDODRINE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
Migergot suppository ![Compare how all Medicare Part D PDP plans in PA cover Migergot suppository.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MIGLUSTAT 100 MG CAPSULE [Zavesca] ![Compare how all Medicare Part D PDP plans in PA cover MIGLUSTAT 100 MG CAPSULE [Zavesca].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
MILI 0.25-0.035 MG TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in PA cover MILI 0.25-0.035 MG TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIMVEY 1-0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIMVEY 1-0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MIMVEY LO 0.5-0.1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIMVEY LO 0.5-0.1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MINOCYCLINE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MINOCYCLINE 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MINOCYCLINE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MINOCYCLINE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MINOXIDIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MINOXIDIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MINOXIDIL 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MINOXIDIL 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIRTAZAPINE 15 MG ODT ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 15 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIRTAZAPINE 15 MG TABLET [Remeron] ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 15 MG TABLET [Remeron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MIRTAZAPINE 30 MG ODT ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 30 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIRTAZAPINE 30 MG TABLET [Remeron] ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 30 MG TABLET [Remeron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Mirtazapine 45 mg odt ![Compare how all Medicare Part D PDP plans in PA cover Mirtazapine 45 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIRTAZAPINE 45 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MIRTAZAPINE 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MIRTAZAPINE 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
misoprostol 100 mcg tablet ![Compare how all Medicare Part D PDP plans in PA cover misoprostol 100 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
misoprostol 200 mcg tablet ![Compare how all Medicare Part D PDP plans in PA cover misoprostol 200 mcg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MITIGARE 0.6 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MITIGARE 0.6 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MODAFINIL 100 MG TABLET [Provigil] ![Compare how all Medicare Part D PDP plans in PA cover MODAFINIL 100 MG TABLET [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | P Q:60 /30Days |
MODAFINIL 200 MG TABLET [Provigil] ![Compare how all Medicare Part D PDP plans in PA cover MODAFINIL 200 MG TABLET [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | P Q:60 /30Days |
Moexipril hcl 15 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Moexipril hcl 15 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOEXIPRIL HCL 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOEXIPRIL HCL 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MOLINDONE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOLINDONE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MOLINDONE HCL 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOLINDONE HCL 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MOLINDONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOLINDONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MOMETASONE FUROATE 0.1% CREAM (g) [Elocon] ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE 0.1% CREAM (g) [Elocon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MOMETASONE FUROATE 0.1% OINT ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE 0.1% OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MOMETASONE FUROATE 0.1% SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover MOMETASONE FUROATE 0.1% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MONDOXYNE NL 100 MG CAPSULE [Monodox] ![Compare how all Medicare Part D PDP plans in PA cover MONDOXYNE NL 100 MG CAPSULE [Monodox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN ![Compare how all Medicare Part D PDP plans in PA cover MONONESSA TABLETS .250;.035MG; MG 6 X 28 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MONTELUKAST SOD 10 MG TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover MONTELUKAST SOD 10 MG TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:30 /30Days |
MONTELUKAST SOD 4 MG TAB CHEW [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover MONTELUKAST SOD 4 MG TAB CHEW [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MONTELUKAST SOD 5 MG TAB CHEW [Singulair] ![Compare how all Medicare Part D PDP plans in PA cover MONTELUKAST SOD 5 MG TAB CHEW [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:30 /30Days |
MORGIDOX 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MORGIDOX 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MORPHINE SULF 10 MG/5 ML Solution [MSIR] ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF 10 MG/5 ML Solution [MSIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:900 /30Days |
MORPHINE SULF 20 MG/5 ML Solution [MSIR] ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF 20 MG/5 ML Solution [MSIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:900 /30Days |
MORPHINE SULF ER 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF ER 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MORPHINE SULF ER 15 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF ER 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:90 /30Days |
MORPHINE SULF ER 200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF ER 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MORPHINE SULF ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:90 /30Days |
MORPHINE SULF ER 60 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULF ER 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | Q:90 /30Days |
MORPHINE SULFATE 100 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 100 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MORPHINE SULFATE 15MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 15MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE 30MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover MORPHINE SULFATE 30MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | Q:180 /30Days |
MOVANTIK 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOVANTIK 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | Q:30 /30Days |
MOVANTIK 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MOVANTIK 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | Q:30 /30Days |
MOXIFLOXACIN 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in PA cover MOXIFLOXACIN 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MOXIFLOXACIN 400 MG/250 ML BAG PIGGYBACK [Avelox I.V.] ![Compare how all Medicare Part D PDP plans in PA cover MOXIFLOXACIN 400 MG/250 ML BAG PIGGYBACK [Avelox I.V.].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MOXIFLOXACIN HCL 400 MG TABLET [Avelox] ![Compare how all Medicare Part D PDP plans in PA cover MOXIFLOXACIN HCL 400 MG TABLET [Avelox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MULPLETA 3 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MULPLETA 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:7 /30Days |
Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | None |
MUPIROCIN 2% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover MUPIROCIN 2% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$6.00 | $12.00 | None |
MYALEPT 11.3 MG (5 MG/ML) VIAL ![Compare how all Medicare Part D PDP plans in PA cover MYALEPT 11.3 MG (5 MG/ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
MYCAMINE 100MG/VIAL FOR INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover MYCAMINE 100MG/VIAL FOR INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MYCAMINE 50MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover MYCAMINE 50MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MYCOPHENOLATE 200 MG/ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE 200 MG/ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
MYCOPHENOLATE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MYCOPHENOLATE 500 MG TABLET [CellCept] ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLATE 500 MG TABLET [CellCept].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MYCOPHENOLIC ACID DR 180 MG TB ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLIC ACID DR 180 MG TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MYCOPHENOLIC ACID DR 360 MG TB ![Compare how all Medicare Part D PDP plans in PA cover MYCOPHENOLIC ACID DR 360 MG TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P |
MYORISAN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYORISAN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MYORISAN 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYORISAN 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
Myorisan 30 mg capsule ![Compare how all Medicare Part D PDP plans in PA cover Myorisan 30 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MYORISAN 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover MYORISAN 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | None |
MYRBETRIQ ER 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MYRBETRIQ ER 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MYRBETRIQ ER 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover MYRBETRIQ ER 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$10.00 | $25.00 | Q:30 /30Days |
MYTESI 125 MG DR TABLET ![Compare how all Medicare Part D PDP plans in PA cover MYTESI 125 MG DR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
46% | 46% | P Q:60 /30Days |