2020 Medicare Part D Plan Formulary Information |
Medicare Plus Blue PPO Vitality (PPO) (H9572-002-4)
Benefit Details
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Vitality (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Medicare Plus Blue PPO Vitality (PPO) (H9572-002-4) Formulary Drugs Starting with the Letter P in Lake County, MI: CMS MA Region 11 which includes: MI Plan Monthly Premium: $79.00 Deductible: $100 |
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 MI cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PACERONE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PACERONE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PACERONE 400MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PACERONE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PALIPERIDONE ER 1.5 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in MI cover PALIPERIDONE ER 1.5 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | Q:90 /90Days |
PALIPERIDONE ER 3 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in MI cover PALIPERIDONE ER 3 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | Q:90 /90Days |
PALIPERIDONE ER 6 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in MI cover PALIPERIDONE ER 6 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | Q:180 /90Days |
PALIPERIDONE ER 9 MG TABLET [INVEGA] ![Compare how all Medicare Part D PDP plans in MI cover PALIPERIDONE ER 9 MG TABLET [INVEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | Q:90 /90Days |
PALYNZIQ 10 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover PALYNZIQ 10 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PALYNZIQ 2.5 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover PALYNZIQ 2.5 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PALYNZIQ 20 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in MI cover PALYNZIQ 20 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANCREAZE DR 10,500 UNIT CAPSULE DR ![Compare how all Medicare Part D PDP plans in MI cover PANCREAZE DR 10,500 UNIT CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | S |
PANCREAZE DR 16,800 UNIT CAPSULE DR ![Compare how all Medicare Part D PDP plans in MI cover PANCREAZE DR 16,800 UNIT CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | S |
PANCREAZE DR 2,600 UNIT CAPSULE DR ![Compare how all Medicare Part D PDP plans in MI cover PANCREAZE DR 2,600 UNIT CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | S |
PANCREAZE DR 21,000 UNIT CAPSULE DR ![Compare how all Medicare Part D PDP plans in MI cover PANCREAZE DR 21,000 UNIT CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | S |
PANCREAZE DR 4,200 UNIT CAPSULE DR ![Compare how all Medicare Part D PDP plans in MI cover PANCREAZE DR 4,200 UNIT CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | S |
PANRETIN 0.1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in MI cover PANRETIN 0.1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PANTOPRAZOLE SOD DR 20 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PANTOPRAZOLE SOD DR 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PANTOPRAZOLE SOD DR 40 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PANTOPRAZOLE SOD DR 40 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PARICALCITOL 1 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in MI cover PARICALCITOL 1 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PARICALCITOL 2 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in MI cover PARICALCITOL 2 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PARICALCITOL 4 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in MI cover PARICALCITOL 4 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROMOMYCIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PAROMOMYCIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE ER 12.5 MG TABLET 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE ER 12.5 MG TABLET 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE ER 25 MG TABLET 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE ER 25 MG TABLET 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE ER 37.5 MG TABLET ER 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE ER 37.5 MG TABLET ER 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE HCL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE HCL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE HCL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE HCL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PAROXETINE MESYLATE 7.5 MG CAP ![Compare how all Medicare Part D PDP plans in MI cover PAROXETINE MESYLATE 7.5 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in MI cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PAXIL ORAL SUSPENSION 10 MG/5ML ![Compare how all Medicare Part D PDP plans in MI cover PAXIL ORAL SUSPENSION 10 MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAZEO 0.7% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover PAZEO 0.7% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in MI cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PEG 3350-ELECTROLYTE SOLUTION RECON [TriLyte] ![Compare how all Medicare Part D PDP plans in MI cover PEG 3350-ELECTROLYTE SOLUTION RECON [TriLyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PEG-3350 AND ELECTROLYTES SOLN SOLN RECON ![Compare how all Medicare Part D PDP plans in MI cover PEG-3350 AND ELECTROLYTES SOLN SOLN RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PEGANONE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PEGANONE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PEGASYS PROCLICK 180 MCG/0.5 ![Compare how all Medicare Part D PDP plans in MI cover PEGASYS PROCLICK 180 MCG/0.5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | Q:4 /28Days |
PEMAZYRE 13.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PEMAZYRE 13.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PEMAZYRE 4.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PEMAZYRE 4.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PEMAZYRE 9 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PEMAZYRE 9 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PENICILLAMINE 250 MG TABLET [Depen] ![Compare how all Medicare Part D PDP plans in MI cover PENICILLAMINE 250 MG TABLET [Depen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 MI 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 |
Tier 4 |
50% | 50% | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PENICILLIN VK 125 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN VK 125 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PENICILLIN VK 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN VK 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PENICILLIN VK 500 MG TABLET [Veetids] ![Compare how all Medicare Part D PDP plans in MI cover PENICILLIN VK 500 MG TABLET [Veetids].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PENTAM 300 INJ 300MG ![Compare how all Medicare Part D PDP plans in MI cover PENTAM 300 INJ 300MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PENTAMIDINE 300 MG VIAL [Pentam] ![Compare how all Medicare Part D PDP plans in MI cover PENTAMIDINE 300 MG VIAL [Pentam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PENTASA 250MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MI cover PENTASA 250MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PENTASA 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PENTASA 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in MI cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PERINDOPRIL ERBUMINE 2 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PERINDOPRIL ERBUMINE 2 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERINDOPRIL ERBUMINE 4 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PERINDOPRIL ERBUMINE 4 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | None |
PERINDOPRIL ERBUMINE 8 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PERINDOPRIL ERBUMINE 8 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | None |
Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MI cover Permethrin 50mg/g 1 TUBE per CARTON / 60 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PERPHENAZINE 16 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE 16 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PERPHENAZINE 2 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE 2 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PERPHENAZINE 4 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE 4 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PERPHENAZINE 8 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in MI cover PERPHENAZINE 8 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PERSERIS ER 120 MG SYRINGE KIT SUSER SYKT ![Compare how all Medicare Part D PDP plans in MI cover PERSERIS ER 120 MG SYRINGE KIT SUSER SYKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | S |
PERSERIS ER 90 MG SYRINGE KIT SUSER SYKT ![Compare how all Medicare Part D PDP plans in MI cover PERSERIS ER 90 MG SYRINGE KIT SUSER SYKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | S |
PERTZYE DR 24,000 UNIT CAPSULE DR ![Compare how all Medicare Part D PDP plans in MI cover PERTZYE DR 24,000 UNIT CAPSULE DR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MI cover Phenelzine Sulfate 15mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Phenobarbital 100mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Phenobarbital 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 15 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 16.2 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 16.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 20 MG/5 ML ELIX ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 20 MG/5 ML ELIX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 32.4 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 32.4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Phenobarbital 60mg/1 ![Compare how all Medicare Part D PDP plans in MI cover Phenobarbital 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 64.8 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 64.8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENOBARBITAL 97.2 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PHENOBARBITAL 97.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION [Dilantin] ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN 125 MG/5 ML ORAL SUSPENSION [Dilantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENYTOIN 50 MG CHEWABLE TABLET [Dilantin] ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN 50 MG CHEWABLE TABLET [Dilantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENYTOIN SOD EXT 100 MG CAP ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN SOD EXT 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENYTOIN SOD EXT 200 MG CAP ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN SOD EXT 200 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PHENYTOIN SOD EXT 300 MG CAPSULE [Phenytek] ![Compare how all Medicare Part D PDP plans in MI cover PHENYTOIN SOD EXT 300 MG CAPSULE [Phenytek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PICATO 0.015% GEL ![Compare how all Medicare Part D PDP plans in MI cover PICATO 0.015% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | Q:3 /31Days |
PICATO 0.05% GEL ![Compare how all Medicare Part D PDP plans in MI cover PICATO 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | Q:2 /31Days |
PIFELTRO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PIFELTRO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |
PILOCARPINE 1% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE 1% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PILOCARPINE 2% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE 2% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PILOCARPINE 4% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE 4% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PILOCARPINE HCL 5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE HCL 5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PILOCARPINE HCL 7.5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in MI cover PILOCARPINE HCL 7.5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIMOZIDE 1 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in MI cover PIMOZIDE 1 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PIMOZIDE 2 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in MI cover PIMOZIDE 2 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PINDOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PINDOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PINDOLOL 5 MG TABLET [Visken] ![Compare how all Medicare Part D PDP plans in MI cover PINDOLOL 5 MG TABLET [Visken].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PIOGLITAZONE HCL 15 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE HCL 15 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PIOGLITAZONE HCL 30 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE HCL 30 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PIOGLITAZONE HCL 45 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE HCL 45 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact] ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | Q:90 /90Days |
PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact] ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | Q:90 /90Days |
PIOGLITAZONE-METFORMIN 15-500 TABLET [Actoplus Met] ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE-METFORMIN 15-500 TABLET [Actoplus Met].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:270 /90Days |
PIOGLITAZONE-METFORMIN 15-850 ![Compare how all Medicare Part D PDP plans in MI cover PIOGLITAZONE-METFORMIN 15-850.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:270 /90Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIPERACIL-TAZOBACT 2.25 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in MI cover PIPERACIL-TAZOBACT 2.25 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PIPERACIL-TAZOBACT 3.375 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in MI cover PIPERACIL-TAZOBACT 3.375 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PIPERACIL-TAZOBACT 4.5 GM VIAL ![Compare how all Medicare Part D PDP plans in MI cover PIPERACIL-TAZOBACT 4.5 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PIQRAY 200 MG DAILY DOSE TABLET ![Compare how all Medicare Part D PDP plans in MI cover PIQRAY 200 MG DAILY DOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PIQRAY 250 MG DAILY DOSE TABLET ![Compare how all Medicare Part D PDP plans in MI cover PIQRAY 250 MG DAILY DOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PIQRAY 300 MG DAILY DOSE TABLET ![Compare how all Medicare Part D PDP plans in MI cover PIQRAY 300 MG DAILY DOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PIROXICAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PIROXICAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PIROXICAM 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PIROXICAM 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PLASMA-LYTE 148 IV SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PLASMA-LYTE 148 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML; ![Compare how all Medicare Part D PDP plans in MI cover PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PLEGRIDY 125 MCG/0.5 ML PEN ![Compare how all Medicare Part D PDP plans in MI cover PLEGRIDY 125 MCG/0.5 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PLEGRIDY 125 MCG/0.5 ML SYRING ![Compare how all Medicare Part D PDP plans in MI cover PLEGRIDY 125 MCG/0.5 ML SYRING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PLEGRIDY PEN INJ STARTER PACK ![Compare how all Medicare Part D PDP plans in MI cover PLEGRIDY PEN INJ STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PLEGRIDY SYRINGE STARTER PACK ![Compare how all Medicare Part D PDP plans in MI cover PLEGRIDY SYRINGE STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PODOFILOX 0.5% TOPICAL TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PODOFILOX 0.5% TOPICAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POLYMYXIN B SULFATE VIAL ![Compare how all Medicare Part D PDP plans in MI cover POLYMYXIN B SULFATE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
POLYMYXIN B-TMP EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover POLYMYXIN B-TMP EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POMALYST 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover POMALYST 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P Q:31 /31Days |
POMALYST 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover POMALYST 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P Q:31 /31Days |
POMALYST 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover POMALYST 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P Q:31 /31Days |
POMALYST 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover POMALYST 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P Q:31 /31Days |
POSACONAZOLE DR 100 MG TABLET [Noxafil] ![Compare how all Medicare Part D PDP plans in MI cover POSACONAZOLE DR 100 MG TABLET [Noxafil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | Q:93 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Potassium Chloride 8 MEQ Extended Release Oral Tablet ![Compare how all Medicare Part D PDP plans in MI cover Potassium Chloride 8 MEQ Extended Release Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in MI cover Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | 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 MI cover Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
POTASSIUM CITRATE ER 10 MEQ TB ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CITRATE ER 10 MEQ TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CITRATE ER 15 MEQ TABLET ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CITRATE ER 15 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CITRATE ER 5 MEQ TAB ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CITRATE ER 5 MEQ TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CL 10 MEQ/100 ML SOL PIGGYBACK ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL 10 MEQ/100 ML SOL PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
POTASSIUM CL 10% (20 MEQ/15ML) Liquid [Kay Ciel] ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL 10% (20 MEQ/15ML) Liquid [Kay Ciel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CL 20 MEQ-0.45% NACL IV SOLN ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL 20 MEQ-0.45% NACL IV SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
POTASSIUM CL 20 MEQ/100 ML SOL PIGGYBACK ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL 20 MEQ/100 ML SOL PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
POTASSIUM CL 20% (40 MEQ/15ML) Liquid [Kaon-CL] ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL 20% (40 MEQ/15ML) Liquid [Kaon-CL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CL 40 MEQ/100 ML SOL PIGGYBACK ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL 40 MEQ/100 ML SOL PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
POTASSIUM CL ER 10 MEQ CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL ER 10 MEQ CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL ER 10 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CL ER 10 MEQ TABLET [Klotrix] ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL ER 10 MEQ TABLET [Klotrix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CL ER 20 MEQ TABLET ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL ER 20 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Potassium cl er 20 meq tablet ![Compare how all Medicare Part D PDP plans in MI cover Potassium cl er 20 meq tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps] ![Compare how all Medicare Part D PDP plans in MI cover POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRADAXA 110 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRADAXA 110 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRADAXA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRADAXA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRADAXA 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRADAXA 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRALUENT 150 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in MI cover PRALUENT 150 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRALUENT 75 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in MI cover PRALUENT 75 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PRAMIPEXOLE 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAMIPEXOLE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAMIPEXOLE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAMIPEXOLE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAMIPEXOLE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAMIPEXOLE 1.5 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE 1.5 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAMIPEXOLE ER 0.375 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 0.375 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRAMIPEXOLE ER 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRAMIPEXOLE ER 1.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 1.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRAMIPEXOLE ER 2.25 MG TABLET ER 24H [Mirapex ER] ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 2.25 MG TABLET ER 24H [Mirapex ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAMIPEXOLE ER 3 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRAMIPEXOLE ER 3.75 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 3.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRAMIPEXOLE ER 4.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRAMIPEXOLE ER 4.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRASUGREL 10 MG TABLET [Effient] ![Compare how all Medicare Part D PDP plans in MI cover PRASUGREL 10 MG TABLET [Effient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRASUGREL 5 MG TABLET [Effient] ![Compare how all Medicare Part D PDP plans in MI cover PRASUGREL 5 MG TABLET [Effient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRAVASTATIN SODIUM 10 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 10 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PRAVASTATIN SODIUM 20 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PRAVASTATIN SODIUM 40 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 40 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PRAVASTATIN SODIUM 80 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in MI cover PRAVASTATIN SODIUM 80 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
6* |
Tier 6 |
$0.00 | $0.00 | Q:90 /90Days |
PRAZIQUANTEL 600 MG TABLET [Biltricide] ![Compare how all Medicare Part D PDP plans in MI cover PRAZIQUANTEL 600 MG TABLET [Biltricide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAZOSIN 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRAZOSIN 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAZOSIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRAZOSIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRAZOSIN 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PRAZOSIN 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR ![Compare how all Medicare Part D PDP plans in MI cover PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRED MILD 0.12% EYE DROPS ![Compare how all Medicare Part D PDP plans in MI cover PRED MILD 0.12% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PRED-G S.O.P. EYE OINTMENT ![Compare how all Medicare Part D PDP plans in MI cover PRED-G S.O.P. EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PREDNICARBATE 0.1% OINTMENT [Dermatop] ![Compare how all Medicare Part D PDP plans in MI cover PREDNICARBATE 0.1% OINTMENT [Dermatop].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Prednisolone 10 mg/5 ml soln ![Compare how all Medicare Part D PDP plans in MI cover Prednisolone 10 mg/5 ml soln.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PREDNISOLONE 15 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE 15 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISOLONE 20 MG/5 ML SOLUTION [Veripred-20] ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE 20 MG/5 ML SOLUTION [Veripred-20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISOLONE AC 1% EYE DROP ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE AC 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISOLONE ODT 15 MG TABLET RAPDIS [Orapred ODT] ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE ODT 15 MG TABLET RAPDIS [Orapred ODT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISOLONE ODT 30 MG TABLET RAPDIS [Orapred ODT] ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE ODT 30 MG TABLET RAPDIS [Orapred ODT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISOLONE SOD PH 25 MG/5 ML ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE SOD PH 25 MG/5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREDNISOLONE SODIUM PHOSPHATE 5MG /5ML ORAL SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 10 MG TABLET [Sterapred DS] ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 10 MG TABLET [Sterapred DS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 10 MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 10 MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 10 MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 10 MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 20 MG TABLET [Predone] ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 20 MG TABLET [Predone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 5 MG TABLET [Sterapred] ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5 MG TABLET [Sterapred].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 5 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREGABALIN 100 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 100 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:270 /90Days |
PREGABALIN 150 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 150 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:270 /90Days |
PREGABALIN 20 MG/ML SOLUTION [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 20 MG/ML SOLUTION [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:2700 /90Days |
PREGABALIN 200 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 200 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:270 /90Days |
PREGABALIN 225 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 225 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:180 /90Days |
PREGABALIN 25 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 25 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:360 /90Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREGABALIN 300 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 300 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:180 /90Days |
PREGABALIN 50 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 50 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:270 /90Days |
PREGABALIN 75 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in MI cover PREGABALIN 75 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | Q:360 /90Days |
Premarin 0.625mg/g ![Compare how all Medicare Part D PDP plans in MI cover Premarin 0.625mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in MI cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | P |
PRETOMANID 200 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRETOMANID 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PREVALITE PACKET ![Compare how all Medicare Part D PDP plans in MI cover PREVALITE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREVIFEM TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in MI cover PREVIFEM TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PREZCOBIX 800 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREZCOBIX 800 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |
PREZISTA 100 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA 100 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |
PREZISTA 150MG TABLETS ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREZISTA 800 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in MI cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PRIFTIN 150 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PRIFTIN 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
Primaquine Phosphate 26.3 MG Oral Tablet ![Compare how all Medicare Part D PDP plans in MI cover Primaquine Phosphate 26.3 MG Oral Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PRIMIDONE 250 MG TABLET [Mysoline] ![Compare how all Medicare Part D PDP plans in MI cover PRIMIDONE 250 MG TABLET [Mysoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRIMIDONE 50 MG TABLET [Mysoline] ![Compare how all Medicare Part D PDP plans in MI cover PRIMIDONE 50 MG TABLET [Mysoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PRIVIGEN 10% VIAL ![Compare how all Medicare Part D PDP plans in MI cover PRIVIGEN 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROAIR HFA 90 MCG INHALER ![Compare how all Medicare Part D PDP plans in MI cover PROAIR HFA 90 MCG INHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | Q:102 /90Days |
PROAIR RESPICLICK INHAL POWDER ![Compare how all Medicare Part D PDP plans in MI cover PROAIR RESPICLICK INHAL POWDER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | Q:12 /90Days |
PROBENECID 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROBENECID 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROBENECID-COLCHICINE TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROBENECID-COLCHICINE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROCHLORPERAZINE 10 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROCHLORPERAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in MI cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PROCRIT 3,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 3,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PROCRIT 4,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 4,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in MI cover PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROCTO-MED HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in MI cover PROCTO-MED HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in MI cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in MI cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROGESTERONE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROGESTERONE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROGESTERONE 200 MG CAPSULE [Prometrium] ![Compare how all Medicare Part D PDP plans in MI cover PROGESTERONE 200 MG CAPSULE [Prometrium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROGLYCEM 50 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MI cover PROGLYCEM 50 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | None |
PROGRAF 0.2 MG GRANULE PACKET ![Compare how all Medicare Part D PDP plans in MI cover PROGRAF 0.2 MG GRANULE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PROGRAF 1 MG GRANULE PACKET ![Compare how all Medicare Part D PDP plans in MI cover PROGRAF 1 MG GRANULE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | P |
PROLASTIN C 1,000 MG VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROLASTIN C 1,000 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROLIA 60MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in MI cover PROLIA 60MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
50% | 50% | P |
PROMACTA 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROMACTA 25 MG SUSPENSION POWDER PACK ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA 25 MG SUSPENSION POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMACTA 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROMACTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROMACTA 75 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMACTA 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PROMETHAZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain] ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in MI cover PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHEGAN 25MG SUPP ![Compare how all Medicare Part D PDP plans in MI cover PROMETHEGAN 25MG SUPP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROMETHEGAN 50MG SUPPOS ![Compare how all Medicare Part D PDP plans in MI cover PROMETHEGAN 50MG SUPPOS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPAFENONE HCL 150 MG TABLET [Rythmol] ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL 150 MG TABLET [Rythmol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPAFENONE HCL 300 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL 300 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPAFENONE HCL ER 225 MG CAP ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HCL ER 225 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in MI cover PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPRANOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROPRANOLOL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL 80 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL 80 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL ER 160 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL ER 160 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL ER 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL ER 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL/HCTZ 40/25 TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL/HCTZ 40/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPRANOLOL/HCTZ 80/25 TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPRANOLOL/HCTZ 80/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Tier 1 |
$2.00 | $6.00 | None |
PROPYLTHIOURACIL 50MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PROPYLTHIOURACIL 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in MI cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PROTRIPTYLINE HCL 10 MG TABLET [Vivactil] ![Compare how all Medicare Part D PDP plans in MI cover PROTRIPTYLINE HCL 10 MG TABLET [Vivactil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROTRIPTYLINE HCL 5 MG TABLET [Vivactil] ![Compare how all Medicare Part D PDP plans in MI cover PROTRIPTYLINE HCL 5 MG TABLET [Vivactil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PROVENTIL HFA 90 MCG INHALER HFA AER AD ![Compare how all Medicare Part D PDP plans in MI cover PROVENTIL HFA 90 MCG INHALER HFA AER AD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | Q:81 /90Days |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in MI cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in MI cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$42.00 | $126.00 | None |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in MI cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | P |
PURIXAN 20 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in MI cover PURIXAN 20 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |
PYRAZINAMIDE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PYRAZINAMIDE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PYRIDOSTIGMINE 60 MG/5 ML SOLN SYRUP [Mestinon] ![Compare how all Medicare Part D PDP plans in MI cover PYRIDOSTIGMINE 60 MG/5 ML SOLN SYRUP [Mestinon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PYRIDOSTIGMINE BR 60 MG TABLET ![Compare how all Medicare Part D PDP plans in MI cover PYRIDOSTIGMINE BR 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PYRIDOSTIGMINE BR ER 180 MG TAB ![Compare how all Medicare Part D PDP plans in MI cover PYRIDOSTIGMINE BR ER 180 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$11.00 | $33.00 | None |
PYRIMETHAMINE 25 MG TABLET [Daraprim] ![Compare how all Medicare Part D PDP plans in MI cover PYRIMETHAMINE 25 MG TABLET [Daraprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
31% | N/A | None |